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Full text of "HIV/AIDS: Building Capacity to Better Serve Your Community: A Guide to Strengthening HIV/AIDS Services"

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HIV/AIDS: 



Building Capacity to 

Better Serve Your Community 



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A Guide to Strengthening HIV/AIDS Services 





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Published by: tag^ 

U.S. Department of Health and Human Services 



MH09D9509 




Acknowledgements 



This resource primer was developed for the U.S. Department of Health 
and Human Services (HHS) Office of HIV/AIDS Policy (OHAP) with sup- 
port secured from the Minority AIDS Initiative Fund. We acknowledge 
the contributions of the Altarum Institute; L. Michael Gipson, Faithwalk 
Enterprises, LLC; Educational Services, Inc.; and the Rev. Lora Har- 
grove Chapman. 

Finally, we recognize those unsung heroes who provide HIV/AIDS ser- 
vices daily without fanfare or accolades. Their tireless efforts for the 
most vulnerable in our society are a model of committed service rep- 
licated in community-based and faith-based organizations throughout 
the United States. 








V 






HIV/AIDS: 




Building Capacity to 

Better Serve Your Community 



A Guide to Strengthening HIV/AIDS Services 





A Guide to Strengthening HIV/ AIDS Services 

Table of Contents 



Providing HIV/AIDS Services 1 

History of HIV/AIDS Services 1 

The Importance of Self-Awareness and Values 3 

Funding and Organizational Capacity 4 

Your Organization, Your Community 7 

An Introduction to Organizational Capacity and Readiness 7 

Organizational and Funding Basics 7 

Choosing the Right Program for Your Organization 14 

Mobilizing Your Community 15 

Partnering with the Federal Government to Prevent HIV 19 

An Introduction to the Centers for Disease Control and Prevention (CDC) 19 

CDC • Where to Start and How to Get Involved 20 

An Introduction to the Substance Abuse and Mental Health Services Administration (SAMHSA) 21 

SAMHSA* Where to Start and How to Get Involved 23 

Partnering with Government to Care, House and Support People with HIV/AIDS 25 

An Introduction to the Health Resources and Services Administration (HRSA) 25 

HRSA« Where to Start and How to Get Involved 27 

An Introduction to HOPWA - A Program of the Department of Housing and Urban Development (HUD) 28 

Centers for Medicaid and Medicare Services (CMS) 29 

Resources for Your Work: Applying for Funding 31 

An Introduction to Federal, State and Local Funding for HIV/AIDS 31 

Conclusion 36 

Quick Links 37 

Table of Contents 39 

Key HIV/AIDS Data Sources 40 

Key Policies and Regulations 41 

Doing a Community Assessment 42 

Community Mobilization 43 

Sample Funding Announcement 47 

Sample Memorandum of Understanding 59 

Ryan White HIV/AIDS Treatment Modernization Act Parts A-F Explained 65 

Ryan White Program Definitions 69 

Other Government Resource and Technical Assistance Opportunites 72 

Glossary of HIV/AIDS Terms3 74 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Friends, 

With over 1.2 million Americans living with HIV infection or AIDS, we are at a criti- 
cal time in the HIV/AIDS epidemic. Two current efforts spearheaded by the Obama 
Administration have enormous potential to improve the lives of people infected 
and affected by HIV/AIDS: 1) health reform and its focus on investing in prevention 
and wellness, improving quality of care, and ensuring affordable, quality health 
coverage for all Americans; and 2) the development of a National HIV/AIDS Strat- 
egy that presents a coordinated and sustainable plan for reducing HIV incidence, 
increasing access to care, and reducing HIV-related health disparities. 

The need for strong new and existing partners at the community level to respond 
to the HIV/AIDS crisis has never been more important. It is in all of our best inter- 
ests that viable and indigenous activities, programs, and organizations are at the 
forefront of the U.S. domestic effort to curb the epidemic. This guide will provide 
some of the personal assessment, strategic thinking, and organizational back- 
ground that is essential for getting started in this work, or for taking your existing 
community programs to the next level if you already serve people infected, affected 
or at risk for HIV/AIDS. 

As a community-based or faith-based organization, your most important part- 
nerships and funding opportunities are at the local, regional, and state level. 
Establishing strong relationships and collaborating with these entities can help 
you get essential support and cooperation for effective and sustainable HIV/AIDS 
activities. The Office of HIV/AIDS Policy can act as an additional resource for you 
through this guide and the Web site www.AIDS.gov. We encourage you to use these 
resources and to think critically about how you can best serve your community. 

The brief history of the U.S. HIV/AIDS epidemic contained in this guide is a 
reminder of how far we've come and the many steps required for even moderate 
progress. The history can be a teaching tool so long as it is informed by the current 
developments, influences and challenges of the HIV/AIDS epidemic. As you and 
your colleagues contemplate new or continued involvement in the HIV/AIDS arena, 
take the time to explore your individual and collective values around what is most 
important to you and why you wish to do this work. Honest and comprehensive 
personal and organizational self-assessment will ultimately contribute to your suc- 
cess and susta inability. Our goal through this resource guide is simply to assist you 
in those efforts. 

Sincerely, 




Christopher H. Bates 

Director 

Office of HIV/AIDS Policy 

U. S. Department of Health and Human Services 



section 1 



Providing HIV/AIDS Services 



The HIV/AIDS epidemic is real, and you have made a decision to tackle it 
in your community. You are not alone in your determination, and we are 
dedicated to providing assistance as you serve those in need. This guide 
aims to provide a comprehensive picture of the AIDS service field and 
your potential role in it to help your organization make informed decisions 
about how and where to begin. 

As with many of those involved in this work, you want to make a differ- 
ence in the lives of those living with or affected by HIV/AIDS. There was 
a time in this field when the willingness to roll up one's sleeves and 
get involved was enough. After over 25 years of science, research, and 
evidence-based practices, we now know that just wanting to help and 
possessing a compassionate spirit is only the beginning, and not nearly 
enough. Rudimentary, haphazard training in the health and social service 
professions that once characterized this field are no longer sufficient, 
and selectively choosing which populations to serve is unacceptable. 
The myriad communities at risk are in dire need of educated, thoughtful 
individuals and organizations dedicated to serving all people. We need 
leaders in the HIV/AIDS field who are committed to learning, evolving, 
and developing new skills and sensitivities to best serve their clients and 
combat this epidemic. 



We need leaders in the 

HIV/AIDS field who 

are committed to learning, 

evolving, and developing 

new skills and sensitivities 

to best serve their clients and 

combat this epidemic. 



History of HIV/AIDS Services 

When HIV/AIDS first affected the United States in 1981, there were no 
services, no funds, and a lot of anxiety. No one understood what was 
happening to those who fell ill, and no one understood how this new 
disease was transmitted. People infected with HIV were fired from their 
jobs, displaced from families, and kicked out of their homes. Members of 
the medical profession were confounded regarding the infection and took 
extraordinary precautions to protect themselves, going as far as refusing 
services to patients in need of their care. Even funeral homes sometimes 
refused to bury the bodies of people with HIV/AIDS. Fear and alarm were 
rampant. 

Governments at every level responded slowly to the growing epidemic, 
leaving the care to those whose lives, families, and friends had been 
affected. Misinformation about who could become infected was shared 
with the public by trusted sources, stigmatizing the disease and leading 
to widespread public expressions of prejudice against those affected by 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 1 



Providing HIV/AIDS Services 



Those who first responded to the 

original crisis included friends, 

families, and partners of those 

with HTVIATDS. . . . the courage 

of these small groups of of en 

isolated individuals 

were immeasurable. 



HIV. Since many people assumed that infected individuals were members 
of marginalized populations already stigmatized in the public conscious- 
ness, the resulting response was highly detrimental. 

Randy Shilt's journalistic account in And The Band Played On: Politics, 
People, and the AIDS Epidemic aptly chronicles a frenzied atmosphere, 
institutional inertia, and a sense of desperation among those affected 
by HIV/AIDS that characterized the early years of the epidemic. HIV/AIDS 
has come a long way in almost 30 years, but the specter of those initial 
years lingers in organizational relationships with the local and federal 
government. In fact, past stigma and hysteria are often revived whenever 
the media recognizes that different groups represent the bulk of new HIV 
cases. The face of the modern HIV epidemic may constantly be changing 
and met by the public with some degree of compassion, but the original 
face of AIDS was one constantly beset by fear and neglect. 

Paying Proper Respect 

Those who first responded to the original crisis included friends, families, 
and partners of those with HIV/AIDS. They fed, washed, clothed, housed, 
and advocated for loved ones who were often too weak, demoralized, 
and ravaged by illness to do so for themselves. There also were members 
of the social work and medical professions, and faith-based leaders as 
well, who demanded that institutions and discriminatory administrations 
meet their missions to care for all people in need, regardless of how they 
were infected. Given that the communicable routes for HIV transmission 
were then unknown, the courage of these small groups of often isolated 
individuals were immeasurable. 

Even as partners, friends, and loved ones died by the hundreds, and 
eventually the hundreds of thousands, these newly anointed advocates 
did not end their efforts to address the needs of those with AIDS or at 
risk for HIV. These individuals started the first AIDS service organizations 
(ASOs), clinics, hospices, and housing programs. They drafted the first 
non-discrimination policies in support of people with AIDS and advocated 
for the funding and research that compose the HIV/AIDS field today. 

These advocates provided HIV prevention education in schools, free con- 
doms, and HIV medications to those unable to afford them, and worked 
for the passage of the Ryan White Care Act (now the Ryan White HIV/ 
AIDS Treatment Modernization Act). They did so with little mainstream 
support, plenty of associated stigma, and enormous obstacles. The fact 
that AIDS services are considered a relatively routine aspect of public 
health is a testament to the sacrifices, tenacity, commitment, and vision 
of those who risked their own housing, employment, and relationships to 
build this service arena. These individuals and organizations are more 
than the past; they are your potential partners, collaborators, and pos- 
sibly your organizational competitors for resources. 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Providing HIV/AIDS Services 



section 1 



This history is critical for new parties in the HIV/AIDS field to understand 
because it serves as a backdrop to contemporary conversations about 
AIDS work, particularly regarding local turf and funding issues. The orga- 
nizations founded and sustained by those who lost people to AIDS are 
now institutions that are 10 or 20 years old. No longer maverick agen- 
cies of well-intended individuals, they are now established organizations 
with professional staff and experience. Similarly, many faith-based and 
mainstream organizations that were once timid or absent in addressing 
HIV/AIDS in the early years are now more committed to meeting their 
community needs and actively working to serve those who are living with 
or affected by HIV/AIDS. 



The Importance of Self-Awareness and Values 

In addition to understanding the history of HIV/AIDS, it is crucial for both 
individuals and organizations involved in this work to undergo the regular 
practice of self-reflection. If you have not engaged in any self-reflection 
about why you want to do this work and addressed any biases that exist, 
you may actually do more harm than good. Biases can lead to poor staff 
attitudes, inconsiderate hours of service, environmental barriers such as 
location, and perceptions regarding confidentiality. Oftentimes these bar- 
riers can restrict client access and make it difficult for organizations to 
secure the right partnerships. 

While you and your colleagues are designing plans to serve your com- 
munity, take time to reflect. Explore your individual and collective values 
around topics that go hand in hand with HIV/AIDS work, such as sexual 
practices, sexual identity, drug use, or racial and ethnic identity. This 
reflection will serve you and your community well as you go forward. 

Confidentiality 

An organization's reputation is made or broken by whether individuals 
can confide sensitive information to the volunteers and staff without 
judgment. Your access to this information is a privilege, grounded in your 
role as a provider. Consumers and communities share private informa- 
tion because they view you as a safe, confidential, and non-judgmental 
community resource. Violating that trust is not only a transgression of the 
HIPPA regulations that you are bound by as a health professional, but it 
will also result in hindered provision of HIV/AIDS care, support, or preven- 
tion programs in your community. Without trust, people are less likely 
to take part in your programs and you find it difficult to obtain the data 
needed to maintain and track individual or group progress. 



Explore your individual and 

collective values around topics 

that go hand in hand with 

HIV/AIDS work, such as sexual 

practices, sexual identity, drug 

use, or racial and ethnic identity. 

This reflection will serve you and 

your community well as 



you go forward. 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 1 



Providing HIV/AIDS Services 



Funding and Organizational Capacity 

The HIV/AIDS field has come a long way since 1981. The good news is 
that there are more people interested in combating the epidemic in this 
country than ever before. There is less HIV/AIDS stigma than a decade 
ago and more effective treatments are available to prolong the lives of 
people who are HIV positive. In many parts of the country, it is possible to 
have public discussions about HIV/AIDS without shame or ridicule. All of 
these advances are welcome news. 

At the same time, organizations still face many obstacles and need a 
great deal of support. On average, it takes an organization a minimum 
of two years to become competitive for government funding. Oftentimes, 
once capacity is built, new organizations have to compete with ASOs 
who have been offering services to local communities for years. These 
new organizations are also entering the field at a time when public apa- 
thy towards HIV is on the rise and condom use is declining among risk 
groups. Adolescents and young adults who grew up in the age of AIDS, 
viewing advertisements projecting images of stable HIV positive individu- 
als often consider HIV a manageable, chronic illness contributing to the 
absence of public urgency. 

As a new organization interested in strengthening the services you pro- 
vide to your community, you face many challenges, but here are three 
routes we suggest in building capacity: 

1. Establish a track record through volunteer service and strategic 
alliances with existing organizations to meet gaps in service, or 
reach underserved populations. Even well-funded, established orga- 
nizations need volunteers to meet the full breadth of their community 
obligations. Volunteer service allows individuals and organizations 
new to AIDS work to develop the skills and sensibilities they need to be 
effective in this field. One way to accomplish this is by developing rela- 
tionships with established organizations that have a record of service. 

2. Seek start-up funding through public, private, and corporate foun- 
dations. The requirements for eligibility are more lenient with founda- 
tions, which generally require less documentation, data collection, 
and evaluation systems and provide most of the grant award upfront. 
However, foundations are still highly competitive, especially as more 
organizations feel better-equipped to meet eligibility requirements and 
other funding prerequisites. 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Providing HIV/AIDS Services 



section 1 



3. Provide services with greater refinement, innovation and profes- 
sionalism, and utilize evidence-based practices. Increasingly as a 
prerequisite for funding, grantees are required to have contract-based 
collaborations and partnerships with organizations to fill gaps in ser- 
vices, strengthen a referral mechanism, and maximize funding. More 
and more, grantees are encouraged to hire staff with secondary and 
post-secondary academic degrees in health, education, and social ser- 
vices, instead of following the more liberal hiring practices of the past. 

So what exactly do we mean by capacity? The list at the right is a sample 
of what is typically required of organizations to be eligible and competi- 
tive for local, state, or federal funding. However, your organization must 
bear in mind that even when all of these components are met, funding 
is not guaranteed. Funds are primarily provided through a government 
request for applications or proposals on a cyclical basis, anywhere 
between 1 to 5 years, and the process is highly competitive. 

Knowledge about this field has expanded greatly over nearly 30 years 
of trial and error. Good intentions must be combined with acquisition of 
skills, sensitivity, knowledge, and understanding of where we have been 
and where we are going. If you and your group are prepared to meet the 
demands of this service, the next chapters will assist you in develop- 
ing some of what you need to get started. The rest will come from your 
encounters with the people and organizations who work everyday with 
those infected and affected by HIV/AIDS. Good luck to you as you move 
forward in your journey. 



Capacity Checklist to be eligible 

and competitive for local, state, or federal 
funding , organizations should have: 

□ A demonstrated history providing services 
to the target community 

□ A demonstrated history of providing open, 
welcoming, and culturally appropriate 
services 

□ A demonstrated history of collaborations 
and partnerships with other community- 
based organizations 

□ Documented quality control plans and 
procedures 

□ A computerized client tracking and 
program monitoring system 

□ Ability to collect and analyze client data 

□ Security and confidentiality policies, 
protocols, and procedures 

□ Program monitoring review processes 

□ Proven target community involvement 
in program design, planning, and 
implementation 

□ Ability to provide or coordinate continual 
staff skills training 

□ Ability to design and implement 
qualitative and quantitative evaluation 
plans 

□ A strong referral network for both HIV and 
non-HIV related social services 

□ A 2-month minimum of operational 
reserve funding (since government 
funding occurs on a reimbursement 
basis and can take at least 30 days for 
reimbursement to occur) 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 2 



Your Organization, Your Community 



An Introduction to Organizational Capacity 
and Readiness 

Setting up an organization to fulfill your community's unmet needs 
around HIV/AIDS can be a long, but ultimately rewarding process, and 
one you can accomplish with the right planning and strategic infrastruc- 
ture development. This chapter provides a basic road map to help your 
agency or coalition achieve its goals by establishing a nonprofit eligible 
for government funding from the local to the federal level. 

There are some organizational basics that all community and faith-based 
organizations must address to be eligible for municipal, state, and fed- 
eral HIV/AIDS funding. Some funding criteria are specific to each locality, 
state, or federal agency. Therefore, this chapter only addresses the most 
general requirements and considerations and should not be considered 
exhaustive. The following tips assume that you are planning to establish 
an organization with a 501(c)(3) tax status, a requirement for most gov- 
ernment funding. However, this chapter also may be useful for nonprofits 
that already have their 501(c)(3) tax status for services separate and 
apart from HIV/AIDS, or existing agencies looking to expand into new 
HIV/AIDS service areas. 

Organizational and Funding Basics 

How to Assess Your Readiness 

You know you want to do something about the HIV/AIDS crisis in your 
community. 1 You may even have a tentative plan outlining exactly what 
type of program you want to launch and the group of people you want to 
serve. You may have rallied a group of volunteers around your program 
or agency concept. This is great news, but be prepared for your plans to 
change depending on what you learn from assessing your readiness and 
the community's needs. Research is the first step in organizational readi- 
ness, not only to determine your capacity, but also to assess whether 
your interests match the needs within your community, and available 
funding. 

You may find that there are already several successful, established pro- 
grams in your community that provide the same service that you planned 
to provide. There might be several other unmet service needs in your 



Research is the first step in 

organizational readiness, not 

only to determine your capacity, 

but also to assess whether your 

interests match the needs within 

your community, and 

available funding. 



1 "You" refers to any individual or group interested in establishing a community or faith- 
based organization eligible for government funding. 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 2 



Your Organization, Your Community 



GUIDING QUESTIONS 



□ What services will my organization 
provide? 

□ Is my idea practical and does it fill an 
unmet need in the community? 

□ Who am I interested in serving and who is 
already serving them (or not)? 

□ Am I best suited to meet my potential 
target population's needs? 

□ If not, how can I get to a point that I have 
the capacity to meet those needs? 

□ Who is my competition? What is my 
nonprofit's advantage over existing 
nonprofit organizations? 

□ How will I sustain my operation, and can I 
create a demand for my organization? 

□ What skills, education, and experience do 
I bring to the nonprofit business? 

□ What equipment or supplies will I need? 

□ What financing will I need? 

□ What insurance coverage will I need? 

□ Where will my organization be located? 

□ Is the planned location accessible for the 
target population(s)? 



community, services more suitable for you to provide and more likely 
to be funded. Perhaps it isn't a service, but a target population that is 
underserved. Are you still interested in providing HIV services? Are your 
volunteers still ready to commit their time to community service in HIV/ 
AIDS? In HIV/AIDS work, community and faith-based organizations have 
to prepare to be flexible in the services they provide and the people they 
serve. 

If you decide to become a formal nonprofit organization, the checklist at 
the left provides some baseline considerations you should address first 
to avoid potential problems later: 

While this guide will help you answer some of these questions, additional 
training and guidance is available through the National Minority AIDS 
Council's (NMAC) Organizational Effectiveness series. You can get free 
copies of a series of comprehensive technical assistance manuals and 
guides on CD-ROM from NMAC's web site (www.nmac.org). 

Organizational Tax Status 

For the purpose of funding eligibility, there are two nonprofit organiza- 
tional tax statuses that are important to consider when deciding what 
kind of agency you plan to form and the services you are interested in 
providing. These are the 501(c)(3) and the 501(c)(4) classifications. 

501(c)(3) A 501(c)(3) is a tax law provision granting exemption from the 
federal income tax to nonprofit organizations. The three principal classifi- 
cations of 501(c)(3) organizations are as follows: 

A public charity normally receives a substantial part of its income, 
directly or indirectly, from the general public or from government. If a 
charity's income is coming from too few sources, the charity is at risk 
for losing its 501(c)(3) tax status. Therefore, the charity should ensure 
that its financial support is broad and not limited to a few individuals 
or donors. 

A private foundation, sometimes called a non-operating foundation, 
receives most of its income from investments and endowments. This 
income is used to make grants to other organizations, rather than 
being used for direct services. 

A private operating foundation is a private foundation that devotes 
most of its earnings and assets to the conduct of its tax exempt pur- 
poses, rather than to making grants to other organizations. 

501(c)(4) Agencies with a 501(c)(4) also are tax-exempt nonprofit orga- 
nizations, but they cannot receive tax-deductible donations like a 501(c) 
(3). This designation is for nonprofit organizations that further social wel- 
fare or public good and want to use lobbying as one of their activities. 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Your Organization, Your Community 



section 2 



While both types of organizations must be run as nonprofits that 
do not benefit private stakeholders, and both are exempt from paying 
federal income tax, there are differences between them. The difference 
lies in an organization's political involvement and the ability to offer tax 
deductions for donations. A 501(c)(3) is limited in its political lobbying 
abilities, but donations made to 501(c)(3) agencies are tax deductible. 
Donations to a 501(c)(4) are not tax deductible, but 501(c)(4) charities 
can engage in political campaign activity, so long as it is not the organiza- 
tion's primary activity. 

Determining whether or not to become a formal nonprofit, a civic 
organization or association, or a for-profit business is one of the most 
significant decisions your organization will have to make. Your agency's 
tax exempt status determines the legal structure for your organization, 
the roles and responsibilities of your board and staff, your record keep- 
ing and accounting systems, and the taxes you are accountable for and 
those from which you are exempt. 

The majority of the government funding resources discussed in this 
guide are directed toward nonprofit entities with a 501(c)(3) tax status. 
Therefore, this chapter focuses on establishing a 501(c)(3) organization. 

Basic Infrastructure Considerations 

A nonprofit requires certain basic infrastructure to be considered fully 
operational. The following is a checklist for establishing your basic organi- 
zation infrastructure, including several core capacities that are specific to 
HIV/AIDS services: 

Mission Statement: A mission statement describes an organization's 
values, the services offered to clients, and the group(s) of clients who will 
benefit from these services. 

Board of Directors: Most states require that you recruit at least three 
board members to establish a nonprofit board. There is no cap on the 
number of members a nonprofit board can have, but it should be a 
manageable body that can make quick and efficient decisions. The main 
role of a board is to provide guidance and oversight to an agency's execu- 
tive leadership, specifically the Executive Director or CEO. who in turn is 
responsible for guiding and executing board approved directives with an 
agency's staff. The board is legally responsible for the financial decisions 
of an organization, so it is recommended that an organization get board 
insurance to protect the personal assets of individual board members 
from any organizational liability in the case of a lawsuit. While a nonprofit 
board can begin as a community advisory committee in the exploratory 
and planning phases of a nonprofit, prior to incorporation, a board should 
not be confused with an advisory council. A board is legally responsible 
for a nonprofit, while an advisory council's role is typically to provide a 
channel for direct community involvement in nonprofit policies, practices, 
and procedures, without assuming legal responsibilities. 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 2 



Your Organization, Your Community 



CORE INFRASTRUCTURE 



□ Mission Statement 

□ Board of Directors 

□ Incorporating 

□ Tax Exemptions and Permits 

□ DUNS Number 

□ Employer/Taxpayer Identification Number 
(EIN/TIN) 

D State Single Point of Contact (SSPOC) 
Letter or Registration Receipt (if 
applicable) 

□ Business Plan 

□ Legal Representation 

□ Accounting Services 

□ Insurance 

□ Roles and Responsibilities 

□ Policy and Procedures Manual 

□ HIPPA Compliance 

□ Fiscal Agents and Sponsorship 

□ Physical Space 



Structurally, boards generally have a Board Chair or Board co-Chairs 
responsible for publicly representing an agency's board and for commu- 
nicating the board's interests to the Executive Director. Other key board 
officer positions include treasurer, secretary, governance, and other 
officers responsible for chairing specific committees. Boards generally 
have chaired committees, each focused on a specific aspect of an orga- 
nization (e.g., program, governance, development, community relations, 
etc.). Board members usually serve 1 to 2 year renewable terms and 
are recruited on a staggered schedule to maintain stability by avoiding a 
simultaneous mass exit of an organization's historical memory. Strategic 
board recruitment is crucial to both a board and an organization's suc- 
cess. While it may be easier to identify willing board members from the 
social and public service sectors, diversity in board composition is vital 
to an organization's overall success and reduces the likelihood of conflict 
of interest issues among individual board members. It is also vital to 
include people living with HIV/AIDS on your board. 

Incorporating: All nonprofit entities must file their board approved arti- 
cles of incorporation with their state registry. Some states also require 
that board bylaws be included with the articles of incorporation. Depend- 
ing on the state and the services provided, some cities may require addi- 
tional business licenses, certifications, and report filings as part of their 
checklist of assurances. For frequently asked questions about incorporat- 
ing, visit the Small Business Administration (SBA, www.sba.gov). 

Tax Exemptions and Permits: An organization must apply for 501(c)(3) 
status with the Internal Revenue Service (IRS, www.irs.gov/charities) to 
be eligible for federal tax exemption. After getting approved as a 501(c) 
(3), an organization can then apply for tax exemption at the state level 
from their State Attorney General's office or Secretary of Commerce. Your 
organization may also qualify for a property tax exemption; a visit to your 
local municipal tax assessor will determine your agency's qualifications 
for this exemption. 



DUNS Number: For federal funding, an organization will need to have a 
Data Universal Numbering System (DUNS) Number. This number allows 
the federal government to identify organizations under grants and coop- 
erative agreements. The federal government requires that your organiza- 
tion and/or any of its sub-units have this number. Visit www.whitehouse. 
gov/omb/grants/duns_num_guide.pdf for more information. 

Employer/Taxpayer Identification Number (EIN/TIN): An organization 
will also need to have an Employer or Taxpayer Identification Number (EIN 
or TIN) as assigned by the Internal Revenue Service. 

State Single Point of Contact (SSPOC) Letter or Registration Receipt 
(if applicable): Some federal applications require organizations to inform 



10 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Your Organization, Your Community 



section 2 



a central contact person or agency in their state that they are applying 
for a specific grant. This helps states to keep track of what kinds of funds 
are being requested and coordinate partnerships within a state. Visit 
www.whitehouse.gov/omb/grants/spoc.pdf to find out the requirements 
in your state. 

Business Plan: Even though you may not be establishing a for-profit busi- 
ness, a start-up nonprofit should still create a business plan to assess 
your organization's resource requirements, market needs, competitors, 
budget projections, and scope of work. The Small Business Administra- 
tion's Small Business Planner (www.sba.gov/smallbusinessplanner) has 
tools available for writing a business plan. 

Legal Representation: To establish its articles of incorporation and deal 
with on-going contractual needs, a start-up nonprofit should retain legal 
counsel. The attorney should be experienced in practicing nonprofit or 
tax law, and not a paralegal or other type of legal representative. Once 
an agency has been approved for tax-exempt status, the attorney could 
be eligible for tax deductions for providing pro bono legal services to your 
agency. An organization's legal counsel can also be a board member, but 
an agency may want to consider any potential conflicts of interest for an 
attorney serving in this dual capacity. 

Accounting Services: Many organizations cannot afford to have a full- 
time certified public accountant (CPA) or chief financial officer when get- 
ting started. It is still, however, important that an accountant help set-up 
and maintain a standard bookkeeping system. Many accounting firms 
and independent accounting consultants will set-up and maintain an 
organization's books on a contractual basis. In addition to bookkeeping, 
budget maintenance, and meeting financial reporting requirements, an 
organization will want to have an accountant to conduct financial audits. 
Most nonprofits have to conduct at least one comprehensive financial 
audit every 2 years, since this is a requirement for many public and pri- 
vate foundations. 

Insurance: Board, property, and liability insurance are just the basic 
insurances an organization needs if providing HIV/AIDS services; most 
of these insurances are required for government funding. Additional 
insurance, such as employment compensation insurance, will also be 
legally required once your organization is at the point of hiring staff. An 
insurance agency can help an organization determine what kind and how 
much insurance it needs when getting started. 

Staff: The HIV/AIDS field historically has trained and groomed people 
from the grassroots up to executive positions, with little previous training 
in health education, public health, or human services. That has changed 
as HIV/AIDS care has become a more competitive, technical field. 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



11 



section 2 



Your Organization, Your Community 



ROLES and RESPONSIBILITIES 



Partners An MCA/MCI] should each 
organization's roles and responsibilities: 

□ Clearly define each organizations' roles 
and responsibilities 

□ Specify a start and end date for the 
agreement 

□ Include any documentation and 
monitoring expectations 

□ Identify primary and secondary points of 
contacts for both organizations 

□ Provide brief meeting, communication, 
and dispute resolution plans 

□ Be reviewed by each organization's 
legal counsel and endorsed by senior 
administrators 

□ Be reviewed annually by both 
organizations 

Staff For functional and efficient opera- 
tions and to be eligible for funding organiza- 
tions, should: 

□ Document position descriptions for all 
staff 

□ Document signed confidentiality 
agreements for all staff, volunteers, and 
board members 

□ Document expectations and, when 
appropriate, position descriptions for 
all volunteer staff and volunteer board 
positions 

□ Document police clearance or FBI 
background checks for any positions 
working with clients under age 18 

D Document quarterly, semi-annual, or 
annual staff performance evaluations 

□ Obtain resumes for all full and part-time 
staff positions 

□ Establish locked physical filing systems 
and password protected electronic 
systems 

D Document baseline organizational 

training plans for all staff and volunteers, 
particularly trainings on organizational 
policies and practice, cultural 
competency, and client confidentiality 

For organizations handling medical 
records, document new staff trainings 
on Health Insurance Portability and 
Accountability Act (HIPAA) compliance 



The staff you hire depends on the level of expertise and experience 
needed to adequately serve your community. Staff members need to be 
trained - and preferably credentialed - in public health, health commu- 
nication, social service delivery, and cultural competence. Staff should 
also be representative of your target communities, including people living 
with HIV/AIDS. It is an organization's responsibility to ensure high quality 
services by establishing training plans for staff and taking advantage of 
training and capacity building opportunities as needed. Many govern- 
ment agencies offer capacity building and service delivery trainings on 
a variety of topics. HIV/AIDS is a field that is constantly changing due to 
ongoing innovations and new scientific knowledge. Organizations should 
regularly check federal government Web sites and publications to stay 
abreast of changing federal policies, priorities, and new initiatives. 

Roles and Responsibilities: Many organizations begin with a volunteer 
staff of committed individuals. To be more competitive and to ensure 
staff capacity to fulfill program goals, staff-limited organizations may 
want to partner with larger, more established organizations to augment 
their organizational capacity. In this case, it is important to establish the 
roles and responsibilities of each partner organization. Organizations 
should have a written Memorandum of Agreement (MOA) or Memoran- 
dum of Understanding (MOU) that outlines each organization's roles and 
responsibilities. A sample MOU is included in Appendix F to guide you. 

Equally important to outlining the roles and responsibilities between 
partners is documenting staff roles and responsibilities. In a small 
nonprofit, it is common for a limited number of staff members to wear 
many hats to get the job done. There still need to be clear roles and 
responsibilities that distinguish agency expectations of board members, 
volunteers, senior administrators, and the frontline staff. There also are 
responsibilities every organization must fulfill to ensure client safety and 
confidentiality. 

Policy and Procedures: All organizations with staff, volunteers, or both 
need a written policy and procedures manual. Some types of service, 
including HIV counseling and testing services, require specialized policy 
and procedures manuals for staff and an additional quality assurance 
manual outlining controls, evaluation assessments, and monitoring pro- 
cedures. Usually these policies and procedures are determined by legal 
regulations at the local, state, and/or federal level and are required to 
be implemented as a condition of a grant award. Organizations unsure 
of how to draft such a manual or lacking technical expertise should con- 
tact the funding agency or their local health department for examples of 
manuals in use. 

HIPPA Compliance: An individual's health information is privileged 
and legally protected. Since 1996, health service providers have had 
additional legal responsibilities for protecting the privacy of their clients' 



12 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Your Organization, Your Community 



section 2 



medical information. The Health Information Portability and Accountabil- 
ity Act (HIPPA) has rules regarding the security and management of cli- 
ents' health records, disclosure of clients' medical information or health 
status, and offers stronger, legally bound confidentiality assurances to 
recipients of health services. 

There is often confusion in the health field about which client health 
information is private or confidential and under what circumstances 
organizations are liable for staff breaches in confidentiality. HHS has a 
number of resources to help organizations like yours be HIPPA compliant. 
To determine whether or not you are HIPPA compliant, or to learn how 
to become compliant as a provider, visit the federal Web sites listed in 
Appendix B and be sure to access your state or local health department 
for information on state laws and regulations. 

Fiscal Agents and Sponsorship: Your organization may need to have 
another agency serve as a fiscal agent or sponsor. Fiscal agents are 
ideal for organizations that have not acquired the necessary resources to 
establish a fully operational non-profit and need time to grow. They also 
may be useful in providing an organization with the essential skills and 
capacities to manage finances. If your project plans are only for a short 
time and a formal non-profit entity is not needed, a fiscal agent may be 
the most ideal situation for your group. As previously described, both 
organizations need to draw up an MOA/MOU outlining a timeframe, roles 
and responsibilities, and administrative cost allocations (fiscal agent 
support is generally supplemented through administrative fees and costs 
charged to your organization). Some fiscal agents provide in-kind support 
and do not charge administrative overhead to short-term or new start-up 
non-profits. In either case, a legal agreement should be developed and 
approved by both parties and their legal counsel. 

Physical Space: Contrary to popular belief, it is not necessary to own 
your own building to be eligible for government funding! Start-up orga- 
nizations often rent space from other organizations until they have the 
capacity to rent or own a separate dwelling. Multiple smaller organiza- 
tions may also rent a single large office and share administrative costs 
such as a receptionist, printer, copier, and even accounting services to 
maximize resources. Geographic location, availability of parking, and 
space for confidential testing or discussions are just a few things to con- 
sider when looking for space. 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



13 



section 2 



Your Organization, Your Community 



STEPS IN A COMMUNITY 
NEEDS ASSESSMENT: 



1. Choose a target population 
and a geographic location or 
setting 

2. Review available HIV/AIDS 
surveillance data 

3. Review other HIV/AIDS 
related datasets 

4. Community resource and 
service mapping 



Choosing the Right Program for Your Organization 

Community Needs Assessment 

There are probably already HIV/AIDS services available in your commu- 
nity. There also are most likely gaps in services available or target popu- 
lations receiving services and support. Local, state, and federal agencies 
all require that an organization use local community needs assessment 
and epidemiological surveillance data to decide who they will serve and 
how. 

An organization can conduct its own needs assessment to determine 
what HIV/AIDS services are available for a particular target group in a 
specific geographic area. There are several government and nonprofit 
resources available online that can assist you in planning and imple- 
menting a community needs assessment. Here are some basic steps 
your organization can take to identify a group in your community that you 
will serve, and the group's specific HIV/AIDS service needs: 

Choose a target population and a geographic location or setting: 

Narrow your research to a target population in a certain community or 
setting. For instance, by choosing African American women of childbear- 
ing years who live in Ward five or within the Fayetteville community, you 
narrow the search to a manageable size and are more likely to identify 
gaps in services or resources for this group. Instead of a geographic 
region or a group of people, your organization might choose to research 
services for a group already in a certain setting such as the local jail, 
detox facilities, high schools, or retirement communities, among others. 

Review available HIV/AIDS surveillance data: Federal, state, and many 
large city health agencies release HIV/AIDS surveillance reports outlining 
the HIV and AIDS rates, incidence, and prevalence in a geographic area. 
Local epidemiology surveillance reports are available online through your 
city or state health department. See Appendix A for links to federal HIV/ 
AIDS surveillance reports and other useful datasets. 

Review other HIV/AIDS related datasets: Data on sexually transmitted 
diseases and substance abuse available at the local health department 
can provide powerful arguments for defining a group or community's risk 
for HIV/AIDS. Reproductive health data on abortions and unintended and 
teenage pregnancy rates can also help crystallize a community's risk 
behaviors, as can local incarceration rates, particularly for drug and alco- 
hol related offenses. STDs, drug use, and unintended pregnancy are all 
predictors and co-factors for HIV infection. National nonprofit and advo- 
cacy groups often compile population specific data and release them as 
fact sheets, issue briefs, white papers, and policy position statements 
that can also help you understand your target group and their needs. 
(See Appendix A) 



14 



HIV/AIDS: Building Capacity to Better Serve Your Community • AGuide to Strengthening HIV/AIDS Services 



Your Organization, Your Community 



section 2 



Community resource and service mapping: What are the resources 
available to support the target population in your community? What 
programs and organizations have dedicated resources to serve your 
chosen group? What HIV/AIDS services (e.g., care, housing, psychosocial 
support, prevention, treatment) and HIV/AIDS related co-factors (e.g., 
mental health, drug treatment, poverty prevention programs) exist in your 
community? 

If a community resource map process has not been implemented in 
your area in the last 3 years by another agency, it may be an ideal time 
for you to implement this process. A guide published by the National Cen- 
ter for Secondary Education and Transition (NCSET) provides a step-by- 
step process on community resource mapping. Though the NCSET guide 
is focused on youth with disabilities, the guide is generalizable for any 
community resource mapping process. You can access NCSET's guide at 
www.ncset.org/publications/essentialtools. 

Mobilizing Your Community 

What is community mobilization? 

Community mobilization engages all sectors of the community in an 
effort to address issues of concern to everyone. It brings together policy 
makers and opinion leaders, local, state, and federal governments, pro- 
fessional groups, religious groups, businesses, and individual community 
members. Community mobilization empowers individuals and groups to 
take action and facilitate change. 

Part of the process includes mobilizing necessary resources, disseminat- 
ing information, generating support, and fostering cooperation across 
public and private sector groups in the community. Anyone can initiate a 
community mobilization effort; all it takes is a person or a group to start 
the process and bring others into it. 

Why mobilize the community? 

• Infuse new energy into an issue through community buy-in and 
support 

• Expand the base of community support for an issue or organization 

• Help a community overcome stigma and denial of a health issue 

• Promote local ownership and decision-making 

• Increase cross-sector collaboration and shared resources 

• Limit competition and redundancy of services and outreach efforts 

• Provide a focus for prevention planning and implementation efforts 

• Create public pressure to change laws, polices, and practices 
— progress that could not be made by just one individual or 
organization 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



15 



section 2 



Your Organization, Your Community 



• Increase access to funding opportunities for organizations and 
promote long-term, organizational commitment to social and 
health-related issues 

Who will you need to mobilize in the community? 

For community mobilization efforts addressing HIV/AIDS, it will be most 
effective to gather the support of those who interact with and influence 
groups most at-risk for HIV/AIDS. They include: 

• People living with and affected by HIV/AIDS 

• Heath Care providers 

• Community-based organizations 

• Faith-based organizations 

• Local and state policy makers and opinion leaders 

Partnering with Community-Based Organizations to Address HIV/AIDS 

Addressing HIV/AIDS will not be possible without significant buy-in, 
support, and involvement from community leaders. It is important for 
organizations to build support for efforts that reach out to and partner 
with local and state health departments, community leaders, and orga- 
nizations within affected communities. Their involvement is essential for 
any type of coordinated response to spikes in HIV infection rates, expand- 
ing clinical and laboratory services, and for enhancing health promotion 
interventions. 

Without community buy-in, there can be no community partnerships. 
These groups must be equal partners in the process and can provide 
necessary linkages between community, federal, state, and local efforts. 
The involvement of community-based leaders and organizations can: 

• Facilitate communications that are more effective 

• Restore, build, and maintain trust in affected populations 

• Improve access to and utilization of testing, treatment, and health 
promotion services 

• Ensure the development of culturally competent interventions 

• Encourage participation of community members to build capacity 
to address HIV/AIDS 



16 



I IIV7AIDS: Building Capacity to IVtret Sctve Yout Community • A Guide to Strengthening HIV/AIDS Services 



Your Organization, Your Community 



section 2 



How can community-based organizations get involved 
with HIV/AIDS activities? 

• Contact policy makers at local and state level and inform them 
about the increase of HIV/AIDS in the community and ongoing 
efforts to address the problem 

• Invite a community leader, policy maker, or a guest speaker who is 
involved in HIV/AIDS to speak during a community-wide event 

• Write a "letter-to-the-editor" for local newspapers requesting that 
they inform their readers about the importance of preventing and 
treating HIV/AIDS 

• Partner with neighborhood hospitals, clinics, pharmacies, AIDS 
service organizations, and STD clinics to start a community-wide 
initiative to raise awareness about HIV testing, treatment, and 
prevention 

• Collaborate with other community organizations to determine 
how a coalition can convey the HIV/AIDS testing and prevention 
messages to their constituents 

• Provide frequent progress reports and updates to the community 
about the current status of HIV/AIDS 

Additional details and a phased approach to community mobilization can 
be found in Appendix D. 



HIV/ AIDS: Building Capacity to Bettet Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



17 



section 2 



Your Organization, Your Community 



18 



I f I V/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 3 



Partnering with the Federal Government 
to Prevent HIV 



An Introduction to the Centers for Disease Control and Prevention (CDC) 

An important part of building your organizational capacity is learning about major federal HIV/AIDS initiatives and 
programs, as well as how you can participate in these programs locally and even receive funding. The CDC (www. 
cdc.gov), a part of the Department of Health and Human Services, focuses on developing, supporting, and dis- 
seminating scientific-based solutions to protect the health of people in the United States, and around the world. 
The CDC is the primary federal agency for conducting and supporting public health activities, including coordinat- 
ing prevention efforts for HIV. 



Director Offices (9) 



HIV/AIDS Related CDC Offices 



Office of the Director H^ Other Departments 






JEl&l&j 


■ ■ 


■ 




Coordinating Center 

for Health Promotion 

(CCHP) 




Coordinating Center 

for Infectious Diseases 

(CCID) 



National Center for 

Chronic Disease 

Prevention and Health 

Promotion (NCCDPHP) 



I 



National Center for 

HIV/ AIDS, Viral 

Hepatitis, STD, and TB 

Prevention (NCHHSTP) 



Key Programs and Initiatives 

CDC has two major HIV/AIDS related coordinating centers- 
the Coordinating Center for Health Promotion (CCHP) and 
the Coordinating Center for Infectious Diseases (CCID). 
Within each of these Coordinating Centers are National 
Centers whose programmatic focus is on HIV/AIDS. 

Coordinating Center for Infectious Diseases (CCID) is the 

national authority on the nature of and response to HIV/ 

AIDS in the United States. CCID is home to the: 

National Center for HIV/AIDS, Viral Hepatitis, STD, and 
TB Prevention (NCHHSTP) is responsible for public health 
surveillance, prevention research, and programs to pre- 
vent and control HIV/AIDS, other sexually transmitted dis- 
eases, viral hepatitis, and tuberculosis. Center staff work 
in collaboration with partners at the community, state, 
national, and international level. 

Coordinating Center for Health Promotion (CCHP) plans 

and directs national programs around disease prevention and health promotion in the areas of chronic disease, 

birth defects, disabilities, and genomics. One of CCHP's centers is the: 

National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) is charged with working 
to prevent and control chronic diseases. The center conducts studies to better understand the causes of these 
diseases, supports programs to promote healthy behaviors, and monitors the health of the nation through 
surveys. The center is responsible for programs on topics related to HIV/AIDS such as healthy motherhood, 
women's health, and adolescent health. Critical to the success of NCCDPHP's efforts are partnerships with 
state agencies, community-based organizations, the private sector, and other federal agencies. 



Division of 

Adolescent 

and School 

Health 

(DASH) 




Division of 

Reproductive 

Health 

(DRH) 




Division of 
HIV/AIDS 
Prevention 

Surveillance 
and 

Epidemiology 
(DHAP-SE) 




Division of 

HIV/AIDS 

Prevention 

Intervention 

Research 
and Support 
(DHAP-IRS) 



19 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



CDC • Where to Start and How to Get Involved 



Community Planning Groups 

CDC encourages community and faith-based orga- 
nizations to get involved in HIV prevention activities 
through participation in HIV Prevention Community 
Planning Groups (CPGs). Fifty-nine state and local 
health departments that are CDC grantees coordi- 
nate these CPGs, which have three major goals: 

• Support broad-based community participation 
in HIV prevention planning 

• Identify HIV prevention needs in each 
jurisdiction 

• Ensure that HIV prevention resources target 
priority populations and interventions set forth 
in the comprehensive HIV prevention plan 

It is crucial that community and faith-based organiza- 
tions take the time to find out about and participate 
in their jurisdiction's Community Planning Group, 
including meeting time and location, nomina- 
tions process, and current priorities and previous 
milestones. Participation and contribution to CPG 
initiatives will show your interest and experience in 
helping to reduce HIV incidence in your local area, as 
well as help you influence key decisions on program- 
ming and policy. This is important as you seek to 
apply for funds in HIV prevention services. 

Applying for CDC funding 

CDC provides direct funding to health departments, 
as well as some direct funding to community-based 
organizations. At the community level, CDC funds 
a small number of organizations that replicate the 
science-based programs CDC has endorsed through 
the Diffusion of Effective Behavioral Interventions 
project (DEBI, www.effectiveinterventions.org). 
After you have started working with your local CPG 
and been successful at getting local funding, your 
organization may be in a position to pursue this CDC 
funding. If that is the case, make sure to familiarize 
yourself with the DEBI programs and their evidence 
base. Your organization should also ask some other 
important questions, including: 



1. Decide if you are ready to work with the CDC 

□ Do you know the CDC centers that work on HIV/ 
AIDS and what each has to offer? 

□ Is a particular grant opportunity appropriate for your 
organization? 

□ Have you assembled and maintained current 
project and community data for planning? 

□ Have you reviewed CDC's current funding 
announcements and planned a strategy? 

□ Do you have resources, including a writing team, to 
prepare an application? 

□ Can you write a fully responsive application? 

□ Are you ready to have your application peer- 
reviewed? 

2. Pre-plan and be ready to respond to a funding 
opportunity 

□ Does your organization have a clear mission that 
can help focus your search for resources? 

□ Do you value the importance of building and 
working in coalitions, partnerships, and networks? 

□ Have you done a literature search of needs, science 
and evidence-based models, standards for service 
delivery, and best practices? 

□ Are your mission and plan driven by a community 
needs assessment? 

□ Can you create or use an existing community needs 
assessment to help you? 

□ Is there a local advisory group already central to 
your planning? 



3. Get Data CDC is a world-class resource for data on 
many public health and epidemiologic conditions and top- 
ics, including HIV and AIDS. These data will be helpful to 
you when identifying issues that affect your target popula- 
tion and/or geographic area. 



4. Submit the most competitive application for 
funding CDC has a wealth of information and tools to walk 
you through various stages of planning for and preparing 
a competitive application. Go to www.cdc.gov/about/busi- 
ness/funding.htm to learn more about current opportuni- 
ties and tools to help you prepare your application. 



J 



20 



I IIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Partnering with the Federal Government to Prevent HIV 



section 3 



An Introduction to the Substance Abuse and 
Mental Health Services Administration (SAMHSA) 

This section provides an overview of SAMHSA (www.samhsa.gov), the 
lead federal agency for the prevention, treatment, and surveillance of 
mental health and substance abuse issues. This section also offers 
tips on how to access SAMHSA information and resources for your 
organization. 



Key Programs and Initiatives 

SAMHSA's vision as an agency is "A Life in the Community for Everyone." 
This vision is based on the premise that people of all ages, with or at risk 
for mental or substance use disorders, should have the opportunity for 
a fulfilling life that includes a job, a home, and meaningful personal rela- 
tionships with friends and family. 

SAMHSA's Centers 

Center for Mental Health Services (CMHS) leads the federal govern- 
ment in addressing mental health infrastrucutre capacity of health care 
providers, and the service needs of mental health consumers. CMHS 
helps states improve and increase the quality and range of treatment, 
rehabilitation, and support services for people with mental health disor- 
ders, their families, and communities. 

People with HIV/AIDS may have psychiatric complications such as AIDS- 
related dementia or other mental health disorders. As part of its work, 
CMHS administers HIV/AIDS programs that focus on prevention, educa- 
tion, and delivery of mental health services for persons living with 
HIV/AIDS. 

SAMHSA's HIV/AIDS and Hepatitis Strategic Plan 

In order to address the behavioral health needs of people living with HIV 
and AIDS, each of SAMHSA's three centers has specific HIV/AIDS pro- 
grams and funding opportunities. The goals of SAMHSA's HIV/AIDS and 
Hepatitis Programs are: 

• To make an impact on curbing the nation's HIV/AIDS epidemic 

• To disseminate knowledge about the mental health aspects of 
HIV/AIDS 

• To identify effective approaches for delivering mental health 
services to people living with HIV/AIDS and disseminate these 
findings to health care providers 

• To improve the health outcomes of people living with HIV/AIDS 
who also have a mental health and/or substance use disorder 

A major activity outlined in the HIV/AIDS Strategic Plan is to increase the 
number of SAMHSA grantees that provide HIV testing. All three SAMHSA 
centers also have a role in managing portions of the Minority AIDS Initia- 



Ap proximately [56,3oo]* 

Americans annually become 
infected with HIV. Of these, about 
one-third of those persons are 
co-infected with viral hepatitis 
from similar modes of transmis- 
sion. Only a small percentage of 
individuals at risk for transmis- 
sion of these diseases resulting 
from a substance abuse and/or 
mental health disorders receive 
appropriate prevention and treat- 
ment services 

SAMHSA/CSAT 

*Statistic from CDC, www.cdc. 

gov/hiv/topic/basic, accessed 
11/11/08 



21 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 3 



Partnering with the Federal Government to Prevent HIV 



tive (MAI), a federal initiative that provides funds to community-based 
organizations and others to address HIV/AIDS issues that disproportion- 
ately impact minority communities. 

Center for Substance Abuse Prevention (CSAP) works with states and 
communities to develop comprehensive substance abuse prevention sys- 
tems. CSAP identifies and implements science and evidence-based pro- 
gram models to prevent, reduce, and treat substance abuse in schools, 
workplaces, communities, and within families and social networks. 
CSAP's HIV-specific initiatives include: 

• Targeted Capacity Expansion Initiatives for Substance Abuse 
Prevention 

• HIV Prevention (HIVP) in Minority Communities: Substance Abuse, 
HIV, & Hepatitis Prevention for Minority Populations and Minority 
Reentry Populations in Communities of Color 

Center for Substance Abuse Treatment (CSAT) works with states and 
community groups to improve and expand substance abuse treatment 
services that target those in recovery. CSAT's HIV/AIDS work is primar- 
ily treatment and early intervention services, with the specific intent 
of reaching out to persons at high-risk for HIV, or who are HIV-positive 
and have been historically underserved by substance abuse treatment 
programs. At the same time, CSAT addresses the capacity of existing 
substance abuse service providers and networks to identify and provide 
early intervention services to HIV-positive or at-risk persons they are 
already serving. Further, the 25 states with the highest rate of new HIV 
cases must set aside 5% of their Substance Abuse Prevention and Treat- 
ment Block GrantBlock Grant for HIV prevention activities. 

In addition to these three centers, SAMHSA has the Office of Applied 
Studies (OAS), which provides data on the impact of mental health dis- 
orders and substance abuse, as well as the impact and performance of 
programs that address these issues. 



22 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



SAMHSA* Where to Start and How to Get Involved 



If you want to link to SAMHSA's purpose, strategic 
plan and programs to further your HIV/AIDS work, 
there are specific HIV/AIDS initiatives you should 
review, learn more about and keep on your radar. 
Knowing who SAMHSA funds in your area may give 
your organization an opportunity to obtain techni- 
cal assistance from or partner with those local and 
national organizations. 

Remember: SAMHSA's HIV/AIDS Strategic Plan 
reaches across many of its substance abuse and 
mental health programs. Applying for funds to 
address substance abuse or mental health in your 
community is also addressing and supporting HIV/ 
AIDS prevention, treatment, and access to services 
for persons impacted by the disease. 

1. Decide if you are ready to work with SAMHSA 

□ Do you know SAMHSAs three Centers and what 
each has to offer? 

□ Is a particular grant opportunity appropriate for 
your organization? 

□ Have you assembled and maintained current 
project and community data for planning? 

□ Have you reviewed SAMHSA's funding 
announcements and planned a strategy? 

□ Do you have resources, including a writing team to 
prepare an application? 

□ Can you write a fully responsive application? 

□ Are you ready to have an application peer- 
reviewed? 

2. Pre-plan and be ready to respond to a funding 
opportunity 

D Does your organization have a clear mission that 
can help focus your search for resources? 

□ Do you value the importance of building and 
working in coalitions, partnerships, and networks? 

□ Have you done a literature search of needs, 
science and evidence-based models, standards for 
service delivery and best practices? 

□ Are your mission and plan driven by a community 
needs assessment? 

□ Can you create or use an existing community 
needs assessment to help you? 

□ Is there an advisory group already central to your 
planning? 



3. Get Data Do you know that substance abuse and 
mental health data can keep your staff and programs 
up-to-date and ensure that your HIV/AIDS programs 
are relevant? SAMHSA's Office of Applied Studies 
(OAS) collects and reports data on behavioral health 
practices and issues to assist patients, treatment 
providers, and policy makers in making informed deci- 
sions regarding prevention and treatment. OAS has 
published studies on alcohol, tobacco, marijuana, and 
other drugs, drug-related emergency department epi- 
sodes and medical examiner cases, and the nation's 
substance abuse treatment system. Reports are is- 
sued from the following major OAS data systems: 

• National Survey on Drug Use & Health (NSDUH) 
Series 

• Drug Abuse Warning Network (DAWN) Series 

• Drug and Alcohol Services Information System 
(DASIS) Series 

• National Survey of Substance Abuse Treatment 
Services (N-SSATS) 

• Treatment Episode Data Set (TEDS) 

• Substance Abuse Treatment Facility Locator 

SAMHSA is a great resource for data on mental health 
and substance abuse nationally and locally. This infor- 
mation may be help you identify the main issues that 
impact your targeted population and area/jurisdiction. 
HIV/AIDS, substance abuse, and mental health are 
related and those links are reflected in the data. 

4. Submit the most competitive application for fund- 
ing SAMHSA has a wealth of information on its Web 
site and tools to walk you through the application 
process. Developing Competitive SAMHSA Grant Appli- 
cations is a manual created to help grantees acquire 
the skills and resources needed to plan, write, and 
prepare a competitive grant application for SAMHSA 
funding. You can find the manual online at www.sam- 

hsa.gov/Grants/TA/index.aspx. 



J 



23 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



w** 



wmm^ 






section 4 



Partnering with Government to Care, House 
and Support People with HIV/AIDS 



An Introduction to the Health Resources and Services 
Administration (HRSA) 

HRSA (www.hrsa.gov) is the federal agency charged with improving access to health care 
services for people who have no medical insurance, are isolated, or medically vulner- 
able. HRSA provides technical assistance and financial support to health care providers 
in every state and territory. HRSA grantees in turn provide health care to people who are 
uninsured, people living with HIV/AIDS, pregnant women, mothers, and children. 

HRSA has six bureaus, with one dedicated to HIV/AIDS - the HIV/AIDS Bureau (HAB). HAB 
is responsible for administering funds authorized by Congress through the Ryan White 
HIV/AIDS Treatment Modernization Act of 2006. 

The Ryan White HIV/AIDS Treatment Modernization Act of 2006 (previously known as 
the Ryan White CARE Act) is a federal law that funds services for people living with HIV/ 
AIDS who cannot afford to pay for the care they need. Ryan White helps cities, states, and 
local community-based organizations pay for HIV/AIDS medical and support services, 
including medication. The program also pays for care that is not covered by other pro- 
grams like Medicaid and Medicare. The primary goal of Ryan White is to get those who 
are HIV positive the care they need early on, and provide support to keep them healthy 
over the course of their lives. 

The majority of Ryan White funds are given to cities and states. Many decisions about 
how to use the funds are made by local planning councils and state planning groups. 
These planning groups work as partners with local government. 

Five Major Parts of The Ryan White HIV/AIDS Treatment Modernization Act 

Part A provides funding to metropolitan areas hardest hit by the HIV epidemic 

Part B provides funding to the 50 states, the District of Columbia and U.S. territories 
for comprehensive primary health care. It includes the AIDS Drug Assistance Program 
(ADAP) 

Parte provides direct funding to community-based, early intervention services 

Part D provides funding to organizations supporting health services for infants, chil- 
dren, youth, and women with HIV and their families 

Part F (there is no Part E) includes the Special Projects of National Significance 
(SPNS) Program, innovative models of care, AIDS Education and Training Centers 
(AETC) training for health care providers, the HIV/AIDS Dental Programs, and the 
Minority AIDS Initiative (MAI) to reduce racial/ ethnic disparities in service access and 
outcomes 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



25 



section 4 



Partnering with Government to Care, House and Support People with HIV/AIDS 



A full description of Parts A through F of the Ryan White HIV/AIDS Treat- 
ment Modernization Act can be found in Appendix G. 

Minority AIDS Initiative Through the Ryan White HIV/AIDS Treatment 
Modernization Act of 2006, funds have been awarded under the Minority 
AIDS Initiative (MAI) to improve the quality of care and health outcomes 
in communities of color disproportionately affected by the HIV epidemic. 
The MAI dollars are distributed to states and across eligible metropolitan 
areas based on the number of ethnic minority AIDS cases in each region. 
Funds are to create, modify, or expand culturally and linguistically appro- 
priate HIV care services for these communities. 
Key Legislative Components MAI funds were allocated by Congress 
for a specific purpose, so they have a special Condition of Award (COA). 
Grantees must document the use of MAI funds separately from other 
Ryan White funds, create an MAI Plan, and complete a separate mid-year 
and final progress report. Sub-recipients accessing MAI funds through 
their local Eligible Metropolitan Area (EMA) or state HRSA grantee may be 
asked to show evidence of the following: 

• Compliance with the MAI Condition of Award and related 
requirements 

• Progress in meeting planned objectives 

• Potential grantee technical assistance needs 

• Type and quantity of services delivered and demographics of 
clients served 

• Improvements in access and health outcomes 



26 



I IIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



HRSA • Where to Start and How to Get Involved 



If you want to link to HRSA'S Ryan White HIV/AIDS Program to further your HIV/AIDS work, it is important to 
familiarize yourself with the five parts of the Ryan White Treatment Modernization Act, the granting/subcon- 
tracting policies of the Eligible Metropolitan Area (EMA)or Transitional Grant Area (TGA) of which you are a 
part, and the core medical service or support service you anticipate providing. The information described in 
the previous section may serve as a reference guide while your organization seeks to obtain direct funds, 
technical assistance, or partnerships with local and national organizations already funded to do this work. 



1. Decide if you are ready to work with HRSA or a local 
HRSA grantee 

□ Do you know the five Parts of the Ryan White Act 
and what services each has to offer? 

□ Have you reviewed HRSA or your local HRSA 
grantee's Ryan White funding opportunity 
announcements or notice of funding availability? 

□ Is a particular grant opportunity appropriate for your 
organization? 

□ Have you received appropriate training, licensure, or 
certification to provide the core or support services 
you want to apply for? 

□ Do you have resources, including a writing team, to 
prepare an application? 

□ Can you write a fully responsive application? 

□ Are you ready to have an application peer-reviewed? 

2. Pre-plan and be ready to respond to a 
funding opportunity 

□ Does your organization have a clear mission that 
can help focus your search for resources? 

□ Do you value the importance of building and 
working in coalitions, partnerships, and networks? 

□ Have you done a literature search of needs, science 
and evidence-based models, standards for service 
delivery and best practices? 

□ Are your mission and plan driven by a community 
needs assessment? 

□ Have you obtained the appropriate licenses or 
certifications to provide the core or support services 
you want to provide? 

□ Are there additional local, county, or state 
requirements for providing those services? 

□ Is there a planning council or local advisory group 
central to your planning? 



3. Get Data 

HRSA has valuable and readily available data on Ryan 
White grantees and their programs; statistics on grant 
dollars by program and geographic location; and a 
search engine to locate grantees by program and 
location. These data links on HRSA's Web site can be 
found in Appendix A. 

4. Submit the most competitive application for funding 

HRSA has a wealth of information and tools on its Web 
site to help you determine whether or not your organi- 
zation is eligible to receive direct funding. Visit www. 
hrsa.gov to review current funding opportunities and 
instructions to apply. 

Most community and faith-based organizations pro- 
viding Ryan White supported care to persons living 
with HIV/AIDS receive funding directly from the HRSA 
grantee in their EMA/TGA. In order to receive funding 
announcements and review funding requirements, 
contact your EMA/TGA grantee directly. Get to know 
all of your community partners, state and local health 
departments, and what the Ryan White Program is 
already funding in your area. 



27 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



section 4 



Partnering with Government to Care, House and Support People with HIV/AIDS 



An Introduction to HOPWA - A Program of the Depart- 
ment of Housing and Urban Development (HUD) 

To address housing needs for low-income persons who are living with 
HIV/AIDS and their families, the Department of Housing and Urban 
Development (HUD) manages the Housing Opportunities for Persons with 
AIDS program (HOPWA, www.hud.gov/offices/cpd/aidshousing/index. 
cfm). HOPWA is the only federal program dedicated to the housing needs 
of persons living with HIV/AIDS and their families. Funds are distributed 
to states and cities based on the number of AIDS cases they have then 
made available as part of the area's plan to address local housing 
needs. Grantees partner with nonprofit organizations and housing agen- 
cies to provide housing and support to beneficiaries. Persons who have 
HIV or AIDS and whose incomes are at or below 80% of the Area Median 
Income, which varies from state to state, are eligible for HOPWA housing. 

How are HOPWA Funds Distributed? 

HOPWA distributes program funds using a formula based on the number 
of AIDS cases in a given area. Three-quarters of HOPWA formula funding 
is awarded to qualified state and metropolitan areas with the highest 
number of AIDS cases. One-quarter of the formula funding is awarded 
to metropolitan areas that have a higher-than-average number of AIDS 
cases. 

Competitive Grants Each year, HUD makes approximately 10 percent 
of the HOPWA grant funds available for competitive grant awards. This 
is done through a national competition to select model projects or pro- 
grams. HUD outlines funding availability through an annual Notice of 
Funding Availability (NOFA) that lists available funds and provides instruc- 
tions on how to apply for them. Nonprofit organizations and states, cities, 
and local governments may apply for HOPWA Competitive Program grants 
directly through HUD's NOFA process, or through their state, city, or local 
government. 

Technical Assistance HOPWA National Technical Assistance awards 
are part of a separate competition under the Community Development 
Technical Assistance section of the HUD NOFA. Awards are provided to 
strengthen the management, operation, and capacity of HOPWA grant- 
ees. Nonprofit organizations, states, and units of local government that 
do not qualify for HOPWA Formula Program grants may apply for HOPWA 
Technical Assistance awards. 



28 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Partnering with Government to Care, House and Support People with HIV/AIDS 



section 4 



Centers for Medicaid and Medicare Services (CMS) 

The Centers for Medicare and Medicaid Services (CMS, www.cms.hhs. 
gov) is the federal agency that administers Medicare and the federal 
parts of the Medicaid program. CMS has resources for HIV positive indi- 
viduals that explain the eligibility requirements for Medicare, and that 
can walk them through their state's Medicaid eligibility requirements. It is 
important for your organization to be familiar with CMS' resources, Medi- 
care benefits related to HIV, as well as your state's Medicaid benefits for 
people living with HIV and AIDS. 

Some HIV positive individuals qualify for both Medicare and Medicaid. 
CMS can help individuals determine which programs they qualify for and 
how they can access both programs' services. One CMS service that 
may be critical for Medicare eligible. HIV positive individuals is Medicare 
prescription drug coverage. Established in January 2006. the Medicare 
prescription drug benefit can help those who are HIV positive pay for their 
medications. In fact, all Medicare drug plans cover a nti retroviral medica- 
tions. Through its Web site, CMS offers a publication, Your Guide to Medi- 
care Prescription Drug Coverage, which describes the program, eligibility 
requirements, and the steps people can take to enroll (www.medicare. 
gov/publications/pubs/pdf/11109.pdf). 

As a state administered entitlement, Medicaid benefits for HIV positive 
individuals differ by state and must be confirmed through the state Med- 
icaid agency. The CMS Web site provides a general overview of Medicaid 
and the range of health services potentially covered by Medicaid pro- 
grams. 



WHAT HOPWA SERVICES 
CAN I PROVIDE? 



Housing information services, including 
housing counseling, housing advocacy, fair 
housing information, and housing search and 
assistance 

Resource identification to develop housing 
assistance resources, outreach, and relation- 
ship building with landlords 

Acquisition, rehabilitation, conversion, lease, 
and repairoffacilitiesto provide housing and 
services 

New construction for Single Room Occupancy 
(SRO) and community residences 

Project ortenant-based rental assistance, 
including shared housing arrangements, tran- 
sitional, and permanent housing 

Short-term rent, mortgage, and utility assis- 
tance to prevent homelessness 

Supportive services, including health, mental 
health, case management, and day care 



29 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 






&"*'* 



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section 5 



Resources for Your Work: Applying for Funding 



An Introduction to Federal, State and Local Funding for 
HIV/AIDS 

When you are ready to apply for federal, state, or local funding, there 
are certain steps your organization can take to manage your efforts and 
stay abreast of funding opportunities. In general, there are two ways that 
community-based organizations access federal funds: 1) directly from a 
federal agency, like CDC, SAMHSA, or HRSA, or 2) applying to state or local 
government as a sub-recipient. 

Applying to the Federal Government 

Step 1 If you are applying for direct federal funds, you will need to register 
your organization with www.grants.gov. The full registration process may 
take a couple of weeks, so do this early. Also, be prepared to download 
software from the Web site that will allow you to submit your application. 

Step 2 Determine if the funding application you are responding to requires a 
Letter of Intent. This letter is from your organization to the funding agency 
and states your intent to apply for funding in response to the funding 
announcement. 

Step 3 Complete the Standard Forms created by the OMB to apply for federal 
grants. Note: the forms are submitted as a part of your application pack- 
age. The Standard Forms will be inserted in the application package that 
you get from www.grants.gov. 

Step 4 In addition to the Standard Forms, there are eight basic components 
to creating an application: 1) the proposal summary; 2) introduction of 
organization; 3) the problem statement (or needs assessment); 4) project 
objectives; 5) project methods or design; 6) project evaluation; 7) future 
or committed funding, including long-range plans for keeping your project 
going; and 8) the project budget and a project justification (rationale). 

Step 5 Your application will generally go through two levels of review. This 
process is called an objective review and ensures that the process is fair 
for all applicants. First, there is an initial screening to see if your applica- 
tion follows basic requirements for submission (like number of pages). 
Once this is done, your application will be reviewed by a panel using the 
evaluation criteria outlined in the funding announcement. The panel will 
provide recommendations and the agency is responsible for making the 
final decision about your application. 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



31 



section 5 



Resources for Your Work: Applying for Funding 



Applying to your State or Local Government 

Federal programs allocate funding to states based on the needs of com- 
munities affected by HIV/AIDS within each state. State governments in 
turn award that money to county or city level entities to deliver HIV/ AIDS 
services. 

HIV/AIDS funding to your state or local government may come from these 
major federal programs: 

Discretionary HIV/AIDS Federal Assistance 

• Ryan White HIV/AIDS Treatment Modernization Program 

• AIDS Drug Assistance Program (ADAP) 

• Housing Opportunities for Persons with AIDS 

• Minority HIV/AIDS Initiative 

Entitlement Programs 

• Medicaid 

• Medicare 

• Social Security Disability Insurance (SSDI) 

• Supplemental Security Income (SSI) 

Community and faith-based organizations like yours receive federal 
funding primarily as sub-recipients through county and city offices. This 
means that funds would be awarded by the city health department, for 
example, that has already received them directly from a federal agency, 
and is authorized to make them available to a sub-recipient such as your 
organization. You will have to compete with other organizations for those 
funds by responding to a Request for Applications issued by your state or 
local government. 

Staying On Top of Funding Opportunities 

As this guide has outlined, there are a number of opportunities for 
your organization to obtain financial assistance for HIV/AIDS work. Use 
the www.aids.gov Web site as a point of entry for all kinds of federally 
approved information on HIV/AIDS, including a description of HIV/AIDS 
activities by agency and what kind of funding may be available. Here are 
other steps you can take to stay on top of HIV/AIDS funding opportuni- 
ties: 

Review the Catalog for Federal Domestic Assistance (www.gsa.gov/ 
fdac) to survey the types of HIV/AIDS programs for which federal funds 
are available. 



32 



HIV/AIDS: Building Capacity to Bettet Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Resources for Your Work: Applying for Funding 



section 5 



Go to Grants.gov regularly to search for federal grant opportunities. If 
you find a grant or contract announcement and are interested in apply- 
ing, each announcement will contain a link to download instructions and 
the forms you need. Go to www.grants.gov/applicants/applicant_faqs.jsp 
for more information. 

Go directly to HHS (www.hhs.gov) for funding opportunities. 

Visit CDC's National Prevention Information Network (www.cdcnpin. 
org) for updates on HIV/AIDS funding, as well as related news and 
resources. 

Know your local funders, such as universities, foundations, local govern- 
ment, and local businesses. Develop relationships with these groups. 

Review the Standard Government Forms for submitting a federal 
application, and forms for reporting, well in advance of your application 
deadline. 

Have your attachments ready to go and be prepared to provide the fol- 
lowing complete and up-to-date information for your application: 

□ Proof of your non-profit status 

□ Articles of incorporation and by-laws 

□ List of grants received (grantor, award amount and funding period) 

□ List of committed or potential funding sources, including 
partnership agreements 

□ Audit or CPA letter to confirm adequacy of your financial 
management system 

□ Documentation of cost share commitments 

□ Letters of support from partners and stakeholders 

□ Current list of Board of Directors including names, titles and 
addresses 

□ Resumes of project staff 

□ Strategic Plan that shows the need for the project you are 
proposing 

□ Information that identifies the specific project area, such as: 
Congressional District Number, census blocks and geographical 
boundaries. 



HIV/ AIDS: Building Capacity ro Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



33 



section 5 



Resources for Your Work: Applying for Funding 



Be responsive! It's possible for your application to be deemed non- 
responsive and disqualified if: 

□ The budget you propose exceeds the stated maximum amount of 
individual awards 

□ The application is missing required documents 

□ The page-length of the application exceeds the maximum allowed 

□ The application does not meet the deadline 

Consider an HIV/AIDS program model that works. Many federal pro- 
grams require that the use of best practices and nationally-recognized 
standards for delivery of services. Your application may be assessed in 
part on your ability to implement a best practice in HIV/AIDS. Models that 
have been proven effective already provide you with the best starting 
point for implementing a successful project. You can locate these best 
practice HIV/AIDS program models and standards at: 

□ HIV Prevention - www.cdc.gov/hiv/topics/research/prs/best- 
evidence-intervention.htm; www.cdcnpin.org 

□ HIV Care and Support Services - hab.hrsa.gov/publications.htm 

□ HIV-related Substance Use and Mental Health - www.samhsa.gov/ 
ebpwebguide/index.asp 

If your organization already receives funds directly from the Federal 
Government 

If you are awarded funds from a federal agency like HRSA, CDC, or 
SAMHSA, it's likely that you had an application that was responsive to 
the needs of the federal program, and that you also demonstrated your 
capacity to implement the program. Here's what you should know: 

□ You will receive a grant award notification stating the duration of 
the award, the dollar amount, and a program contact. You also may 
receive a set of attachments that outline basic requirements that 
you must follow. 

□ You will be responsible for meeting the requirements as they 
appear in the OMB Circulars and Code of Federal Regulations. The 
applicable regulations will be clearly referenced in your Notice of 
Grant Award and terms of agreement. 

You have to know the legal obligations that come along with a federal 
grant: 

Financial reporting requirements. To make sure that grant funds are 
used properly, organizations that receive federal funds must file regular 
financial status reports. The basic financial report form is a one-page 
document called Standard Form 269. Many agencies have adapted this 



34 



HIV/AIDS: Building < apacity to Bettci Serve- Your ( :<>mmunity • A Guide to Strengthening HIV/AIDS Services 



Resources for Your Work: Applying for Funding 



Section 5 



form to suit their own programs. You can find a copy of Standard Form 
269 at www.whitehouse.gov/omb/grants/grants_forms.html. 

Cost-sharing/Matching. These are two terms that often are used inter- 
changeably to describe your share or your organization's contribution of 
financial support to the funded program. Not all programs require a finan- 
cial match. If a program does require a match, you will need to determine 
whether you can contribute the required level of funding and pledge to do 
so. A grantee's cost-share or match may be made in cash, in an in-kind 
contribution (such as facilities, equipment, and supplies), or in staff time. 

Record-keeping. Your organization will be required to maintain financial 
and programmatic records for your project for up to three years following 
the project's end date. For some federal programs, it may be longer. 

Performance Reporting. Typically, all grantees are required to submit 
both periodic and final performance reports that detail the project's 
accomplishments, as well as any problems or challenges. The awarding 
agency provides instructions for how to complete the report. 

Audit. All organizations that receive federal funds are subject to basic 
audit requirements. The audits are necessary to make sure that federal 
dollars have been spent properly on legitimate costs. It is important for 
grant recipients to keep accurate records of all transactions conducted 
with federal funds. Most organizations are not audited by the government 
itself, although the federal government has the right to audit any program 
that receives public money at any time. For example, organizations that 
spend less than $500,000 a year in federal funds are generally asked to 
perform a "self-audit." For organizations that spend $500,000 or more 
in federal funds, an audit by an independent legal or accounting firm is 
required. Circular A-133 explains the Single Audit Act requirements for 
grantees receiving $500,000 or more in federal funds. More information 
on audits may be found on the Office of Management and Budget's Web 
site (www.whitehouse.gov/omb/circulars). 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



35 



Conclusion 



If you have read this guide cover-to-cover, you may feel overwhelmed by the 
intricate system of services, resources, and funding that comprise part of our 
national response to HIV and AIDS. Do not be intimidated, be empowered. 
Consider this guide as an instructive and supportive instrument that will help 
you and your community enter the fight against HIV and AIDS and be better 
prepared for this call to service. We expect you to liberally use this guide as 
a reference to explain the HIV/AIDS field, and increase your access to the 
resources, supports, and networks essential to helping you serve those in 
need. 

Using this resource is the first step to meeting your goals in HIV/AIDS ser- 
vices. There is still much to learn and experience before you can effectively 
begin to plan, develop, and implement the high quality services you want to 
provide for your community. HIV/AIDS is a highly dynamic field that requires 
continual learning and reflection to meet people's needs. Those you serve 
deserve nothing less than the best, most informed services and programs to 
help them restore their lives, families, and communities. 

Before you move forward with the many plans and ideas that came to you 
while reading the guide, remember to honestly take stock of yourself and 
your organization before starting on this journey. Take the time to really 
assess yourself and your team for readiness, then take the time to learn 
what is happening in your local community. Who are the players? What are 
the services? And more importantly, who are the clients and what are their 
needs? How do you ensure that you are working with people living with HIV/ 
AIDS at every step? Then, ask yourself again whether you can offer clients 
the best possible solutions to their challenges, or if you are better suited to 
supporting those already working in the community to fight HIV/AIDS. Often 
the best work happens through reinventing or rebuilding an existing asset, 
not in creating a new one. 

Community restoration can come in many forms. Whether your restoration 
effort comes by launching a new program to address unmet needs, or by 
contributing to those agencies needing additional support to improve com- 
munity services, you are still both needed and welcome in this fight. However 
you decide to get involved, by learning more about HIV/AIDS and by consider- 
ing your role in helping to transform and protect the lives in your community, 
you have taken a meaningful first step to beating this disease. If knowledge 
is the first brick in the wall of protection and transformation, restoration for 
you and your community has already begun. 



36 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Quick Links 



AIDS.gov www.aids.gov 

CDC www.cdc.gov 

Preparing a CDC application www.cdc.gov/about/business/funding.htm 

CDC National Prevention Information Network www.cdcnpin.org 

CMS www.cms.hhs.gov 

Federal Grants Information www.grants.gov 

HHS www.hhs.gov 

HRSA HIV/AIDS Bureau hab.hrsa.gov 

HUD HOPWA Program www.hud.gov/offices/cpd/aidshousing 

Internal Revenue Service www.irs.gov/charities 

National Center for Secondary 

Education and Transition www.ncset.org 

National Minority AIDS Council www.nmac.org 

Office of HIV/AIDS Policy www.hhs.gov/ophs/ohap 

OMB www.whitehouse.gov/omb 

DUNS Number www.whitehouse.gov/omb/grants/duns_num_guide.pdf 

State Single Point of Contact Letter www.whitehouse.gov/omb/grants/spoc.pdf 

Standard Form 269 www.whitehouse.gov/omb/grants/grants_forms.html 

Audit information www.whitehouse.gov/omb/circulars 

Ryan White HIV/AIDS Program hab.hrsa.gov/about 

Ryan White Part A Planning Council Primer http://hab.hrsa.gov/tools/pcp08.htm 

SAMHSA www.samhsa.gov 

Developing Competitive Grant Applications www.samhsa.gov/grants/TA/index.aspx 

Small Business Association www.sba.gov 

Small Business Planner www.sba.gov/smallbusinessplanner 



37 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix 

Table of Contents 



Appendix A Key HIV/AIDS Data Sources 44 

Appendix B Key Policies and Regulations 45 

Appendix C Doing a Community Assessment 46 

Appendix D Community Mobilization 47 

Appendix E Sample Funding Announcement 51 

Appendix F Sample Memorandum of Understanding 63 

Appendix G Ryan White HIV/AIDS Treatment Modernization Act: Parts A through F Explained 69 



Appendix H Ryan White Program Definitions 73 

Core Medical Services 
Core Support Services 



Appendix I Other Government Resources and Technical Assistance Opportunities 76 

Glossary of HIV/AIDS Terms 78 



39 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix A 



Key HIV/AIDS Data Sources 



CDC HIV/ AIDS Surveillance Reports www.cdc.gov/hiv/topics/surveillance/resources/reports/index.htm 

State-Level HIV/AIDS Data Tables (visit your local and state 

health department for more detailed data sets) www.cdc.gov/hiv/topics/surveillance/resources/reports/tables.htm 

United States Health Statistics and Trends 2007 

(report published annually) www.cdc.gov/nchs/data/hus/hus07.pdf 

Healthy People 2010 Report and Database 

(federal health goals and benchmarks) wonder.cdc.gov/data2010 

National Center for Health Statistics www.cdc.gov/nchs 

National Behavior Risk Factor Surveillance System www.cdc.gov/brfss 

Youth Risk Behavior Surveillance System www.cdc.gov/HealthyYouth/yrbs/index.htm 

CDC National Prevention Information Network www.cdcnpin.org 

Drug Abuse Warning Network (DAWN) dawninfo.samhsa.gov 

Drug And Alcohol Services Information System (DASIS) www.oas.samhsa.gov/dasis.htm 

National Survey on Drug Use and Health (NSDUH) www.oas.samhsa.gov/nsduh.htm 

HRSA/HAB Program Data hab.hrsa.gov/data 

Providing HIV/AIDS Care hab.hrsa.gov/provide 

HRSA Grant Awards By Program and State stateprofiles.hrsa.gov 

HRSA Grantees by Program and State granteefind.hrsa.gov 

Statewide HOPWA Information www.hud.gov/offices/cpd/aidshousing/local 

Office of Women's Health Quick Health Data Online www.healthstatus2010.com/owh 



40 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix B 



Key Policies and Regulations 



Finding and Applying for Government Grants www.grants.gov 

The Federal Register www.gpoaccess.gov/fr 

U.S. Department of HHS 

Grant Policy Statement www.hhs.gov/grantsnet/adminis/gpd/index.htm 

U.S. Department of HHS Program Support Center Financial Management Service, 
Division of Payment Management Help Desk www.dpm.psc.gov/ 

CDC Grant Reference Information www.cdc.gov/od/pgo/funding/grants/references.shtm 

SAMHSA Grants Management www.samhsa.gov/Grants/management.aspx 

Peer Review Process Guidance www.cdc.gov/od/science/PHResearch/peerreview.htm 

Government Travel Policy and 

Per Diem Rates www.gsa.gov/Portal/ gsa/ep/ChannelView.do?PageTypelD=17113&channel ld=-24651 

Health Insurance Portability and Accountability Act (HIPPA) 

HIPPALaw: www.cms.hhs.gov/HIPAAGenlnfo/Downloads/HIPAALaw.pdf 

HIPPA FAQ: www.hhs.gov/hipaafaq/index.html 

Administrative Simplification Compliance Act 

(1997 amendmentto HIPPA) www.cms.hhs.gov/HIPAAGenlnfo/Downloads/ASCALaw.pdf 

National Standards to Protect the Privacy of 

Personal Health Information www.hhs.gov/ocr/hipaa 

Security Information Series, a group of educational papers designed to give HIPAA covered entities insight into the Security Rule and assis- 
tance with implementation of the security standards. See the links below for pdf downloads of this series: 

Security 101 www.cms.hhs.gov/EducationMaterials/Downloads/Securityl01forCoveredEntities.pdf 

Administrative Safeguards www.cms.hhs.gov/EducationMaterials/Downloads/SecurityStandardsAdministrativeSafeguards.pdf 

Physical Safeguards www.cms.hhs.gov/EducationMaterials/Downloads/SecurityStandardsPhysicalSafeguards.pdf 

Basics of Risk Analysis and 

Risk Management www.cms.hhs.gov/EducationMaterials/Downloads/BasicsofRiskAnalysisandRiskManagement.pdf 

Security Standards www.cms.hhs.gov/EducationMaterials/Downloads/SecurityStandardsOrganizationalPolicies.pdf 

Security Standards Implementation 

for a Small Provider www.cms.hhs.gov/EducationMaterials/Downloads/SmallProvider4final.pdf 



41 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix C 



Doing a Community Assessment 



The following questions will assist you in performing a basic community assessment with community leaders and 
can be adapted and revised as needed: 

Awareness, Resources, and Barriers 

□ Who is affected most by this disease? 

□ What are their races, ethnicities, and genders? 

□ What are their socio-economic levels? 

□ Where do they live? 

□ What other information do you have on this population? 

□ What is the impact of this disease in the community? For the individuals most affected? For their families? 

□ Are there barriers to addressing HIV/AIDS in the community (social, political, economic)? Can they be 
overcome and if so, how? 

□ What are the resources and strengths we have to address HIV/AIDS? 

□ How can we pool these resources and strengths and use them wisely? 

Community Services, Attitudes, Beliefs, and Behaviors 

□ What has been done in the past to address HIV/AIDS in the community? 

□ What are the HIV/AIDS services available now in the community? 

□ Who was involved in HIV/AIDS work in the past, and who is involved now? 

□ If efforts already exist can those who are already involved be enlisted to help? 

□ Are the services being provided stable and sustainable for at least five more years? 

I Which populations are not being served? Exactly what are the services that are not being provided to 
those who are underserved? 

□ What does the community know about HIV/AIDS? 

□ What are the myths and beliefs surrounding HIV/AIDS, if any? 

□ How can these perceptions be changed, if necessary? 

□ What are three major risk behaviors that you see being exhibited in the community, if any? 

□ Does the community see HIV/AIDS as an important issue? 

□ If not, what will make it important to different community groups? 



42 



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appendix D 



Community Mobilization 



What is community mobilization? 2 Community 
mobilization engages all groups of people in a com- 
munity-wide effort to address a health, social, or envi- 
ronmental issue. It brings together policy makers and 
opinion leaders, local, state, and federal governments, 
professional groups, religious groups, businesses, and 
individual community members. Community mobiliza- 
tion empowers individuals and groups to take some 
kind of action to facilitate change. 

Part of the process includes mobilizing necessary 
resources, disseminating information, generating 
support, and fostering cooperation across public and 
private sectors in the community. Anyone can initiate a 
community mobilization effort — the HIV/AIDS division 
staff of local or state health departments. CBOs. or 
concerned physicians and other health professionals. 
All it takes is a person or a group to start the process 
and bring others into it in a participatory way. 
Why mobilize the community? 

• Infuse new energy into an issue through community 
buy-in and support 

• Expand the base of community support for an issue 
or organization 

• Help a community overcome stigma and denial of a 
health issue 

• Promote local ownership and decision-making about 
a health issue 

• Encourage collaboration between individuals and 
organizations 

• Limit competition and duplication of services and 
outreach efforts 

• Provide a focus for prevention planning and 
implementation efforts 

• Create public presence and pressure to change laws, 
polices, and practices — progress that could not be 
made by just one individual or organization 



• Bring new community volunteers together (because 
of increased visibility) 

• Increase cross-sector collaboration and shared 
resources 

• Increase access to funding opportunities for 
organizations and promote long-term, organizational 
commitment to social and health-related issues 

Who will you need to mobilize in the community? 

For community mobilization efforts addressing HIV/ 
AIDS, it will be most effective to gather the support of 
those who have the most interaction and influence with 
the populations most at-risk for HIV/AIDS. They include: 

• Clients and those already infected and affected by 
HIV 

• Heath care providers 

• Community Based Organizations (CBOs) 

• Faith Based Organizations (FBOs) 

• Local and state policy makers and opinion leaders 
(support from policy makers and opinion leaders can 
be achieved through efforts of CBOs and FBOs) 

• Employers 

• Schools 

Mobilizing your community to address HIV/AIDS 

Mobilizing your community to support efforts to 
address HIV/AIDS may seem very challenging, but if 
you break the effort into the following phases, you will 
be able to manage it in a focused and systematic way: 

Phase I: Planning for Community Mobilization 

Phase II: Raising Awareness 

Phase III: Building a Coalition 

Phase IV: Taking Action 

Phase V: Monitoring and Evaluating 



2 This appendix has been adapted from the CDC's "Community 
Mobilization Guide: A Community-Based Effort to Eliminate 
Syphilis in the United States". For more information, visit www. 
cdc.gov/std/see/Community/CommunityGuide.pdf 



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appendix D 



Phase I: Planning for Community Mobilization 

Before you begin any HIV/AIDS work, you must undergo 
a planning phase to help determine the many factors 
that can influence your effort. Begin this phase by: 

• Conducting a Community Assessment (See Appendix 

C for example) 

• Involving the right people (clients, CBO and FBO 
leadership, community stakeholders, etc.) 

• Selecting a strong leader 

• Defining goals and strategies 

• Developing ways to regularly measure progress 

• Identifying funding and other resources 

Action Steps You can begin planning your community 
assessment to identify critical issues and plan future 
interventions by: 

• Interviewing and spending time with community 

members 

• Conducting listening sessions and public forums 

• Reading relevant government reports and other data 
sources 

• Contacting the local, state, and other health 
departments in the region 

• Identifying and working with community leaders and 

others involved in HIV/AIDS 

Once your planning for community mobilization is 
complete, you are ready to move onto the next phases 
of Awareness Raising and Coalition/Partnership 
Building. 

Phase II: Awareness Raising The community 
assessment will help guide you in determining the 
organizations and individuals you should contact and 
the best way to reach them. Begin this phase by: 

• Preparing a community impact statement based 
on the HIV/AIDS problem in your community using 
the community assessment and other available 
information 

• Making the community impact statement available 
in different formats (e.g., editorial, letter, press 
release) 



• Determining the organizations, agencies, and 
individuals who should be involved in this effort and 
how you should get information to them 

• Preparing the case for the issue (e.g., fact sheets, 
case histories) and making it relevant to your 
audience 

• Developing an ongoing dialogue about the issue with 
those with whom you want to partner 

• Approaching a wide spectrum of community leaders 
representing 

Private foundations 

State and local health coalitions 

Non-traditional community leaders from affected 
neighborhoods (e.g., convenience store owners, 
hairdressers, barbers, homeless shelter, and soup 
kitchen personnel) 

Policy makers 

Local media outlets 

School-based clinics 

Heath care providers 

Non-profit hospitals 

Heath insurance companies 

Correction facilities 

Sheriff 's office and police departments 

Drug treatment centers 

Community health centers 

African-American colleges and universities 

African-American fraternities and sororities 

Hispanic and other ethnic organizations 

Gay men's organizations 

Community activists 

Neighborhood associations 

AIDS service organizations (ASOs) 

Action Steps 

• Identify key messages to attract attention to the 
problem and its impact in your community. Create a 
list of appropriate organizations and representatives 
to target 

• Develop background materials for interested parties, 
especially media 



44 



HIV/AIDS: 



I- ( i|).K iry to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix D 



• Start to contact and brief those you would like to 
involve 

• Send out letters and invitations 

• Follow up with a phone call to get a sense of 
partners' interest 

Phase III: Building a Coalition A community mobi- 
lizes when people become aware of a common need 
and decide together to take action to create shared 
benefits. Those concerned about the issue must cre- 
ate the momentum for mobilization — or it cannot be 
sustained over time. Once you decide to mobilize your 
community to conduct or expand HIV/AIDS service and 
prevention activities, you need to build your community 
coalition and partnerships. By building a community 
coalition that may have representation from health care 
providers, policy makers, and CBOs or FBOs leaders 
who serve, treat, and represent your target audience, 
you will build a unified voice and support for HIV/AIDS 
elimination efforts. Remember — there is strength 
in numbers. As you begin this phase, keep in mind 
the need to have the group develop a unified vision. 
A vision is a shared statement of what you want the 
initiative's success to look like. It unifies the different 
community segments that make up your community 
coalition. The coalition's goals, strategies, and activities 
will support this vision. The coalition's vision should 
reflect the findings of the community assessment. 
Begin phase III by: 

• Inviting all interested individuals to a planning 
meeting 

• Using the responses to the letter and invitation as a 
starting point 

• Identifying other community and professional 
networks that can be tapped and enlisted in HIV/ 
AIDS elimination efforts. 

• Preparing and training team members to become 
advocates for addressing HIV/AIDS 



Action Steps 

• Schedule the initial planning meeting 

• Invite all interested individuals and groups that you 
have reached out to, including existing community 
and professional networks 

• At the first meeting, determine your community 
coalition goals 

• Brainstorm with the participants to identify other 
prospective stakeholders and community leaders 
and members you want to join the coalition 

• Determine why they would support HIV/AIDS 
community mobilization efforts, how to best recruit 
them (use information from Phase II) and whether 
they have been involved in previous activities similar 
to this coalition 

• Refer to your Community Assessment findings for 
insight 

• Ensure your coalition is open and diverse and 
includes some "key players" that you know will take 
an active role 

• Share with prospective members of the coalition 
a copy of the Community Assessment, community 
impact statement and any other appropriate 
documents prepared up to this point 

• Develop a shared vision, mission statements, and 
feasible goals 

• Establish your first few meetings and agendas 

Phase IV: Taking Action With your community coali- 
tion in place and goals and vision established, you are 
ready to move into an action and outreach phase. As 
you develop and implement your action plan, keep in 
mind the importance of increasing the awareness and 
knowledge of your target audience and at-risk popula- 
tions about HIV/AIDS. Refer to your Community Assess- 
ment Report and to the Vision and Mission Statements 
developed during earlier phases. The following is an 
outline of the key components of a strategic plan of 
action that can be adapted to your needs. 



45 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix D 



Strategic Plan of Action 

Vision Statement: Your vision is your dream; it's the 

way you think things ought to be. 

Mission Statement: What is going to be done and why. 

Goals: Your goal(s) should have a specific outcome 
attached. You should have short-, mid-, and long- 
term goals. 

Objectives: Specific measurable results of your 
work. A plan may have several objectives; however, 
each objective must support the broader goals. 

Strategies: Broadly describe the paths you are 
going to take to achieve your objectives. There may 
be more than one strategy identified to help reach 
each objective. Each strategy must support the 

objectives. 

Actions: Actions incorporate the specifics of what 
will be done, by whom, by when, and with what 
resources. 

As you determine your actions, remember the 
following tips: 

• You can have different actions to meet your different 
objectives and strategies 

• Your actions may be very specific and be directed 
toward different target audiences such as policy 
makers, health care providers, STD clinic managers, 
community center directors, etc 

• What do you want to change with your actions? 
A certain behavior, perception, or environmental 

norms? 

• If people are going to make a behavior change, what 
changes in their environment need to occur to make 
that happen? 

• Prioritize your actions. You may not be able to do 
everything at once due to limited financial and labor 
resources 

Action Steps Evaluate the type of financial resources 
you have and the resources you need based on the 
information gathered in Phase I. 

• Create a budget document to track these resources 

• Identify resources by categories (e.g., grants, in-kind 
services, volunteers, etc.) 



• Depending on the complexity of the budget, you 
may need coalition members to volunteer to serve 
as treasurer accountant and grant writer of the 
community mobilization effort 

• Maintain the budget by categories to keep track of 
and ensure that projects can be completed with 
available resources 

• Encourage partners to donate financial support and 
services 

Prioritize activities based on funding that is available or 
will be available in the future 

Phase V: Monitoring and Evaluating With any 
community mobilization effort, it is important to keep 
track of activities that are most effective in your com- 
munity and those that may need to be improved upon 
to more successfully meet your goals. 

Action Steps 

• Determine the type of evaluation you plan to conduct 
and how you will collect data 

• Develop both process (e.g., number of brochures 
distributed within a certain timeframe) and outcome 
(e.g., number of people who know about HIV/AIDS) 
measures 

• Research and secure an evaluation contractor if 
needed 

• Determine when in the timeline you are going to 
carry out monitoring and evaluation activities 

• Develop evaluation plans and forms 

• Keep coalition members involved in the evaluation 
activities, as their participation in the data collection 
and agreement on the follow-up actions are critical 
to the ongoing success of the coalition 



46 



I IIV/AII )S: Building ( Opacity to Better Serve Your Com muni ty • A Guide to Strengthening HIV/AIDS Services 



appendix E 



Sample Funding Announcement 




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47 



67566 



Federal Register/Vol. 68, No. 231 /Tuesday, December 2, 2003/Notices 



This form must be signed by the project 
director and authorized business 
official. 

b. You must also include 
documentation of approval by the 
relevant review panel of any HIV 
educational materials used by your 
project. Use the enclosed form Report of 
Approval. If you have nothing to 
submit, you must complete the enclosed 
form No Report Necessary. Either the 
Report of Approval or No Report 
Necessary must be included with all 
progress reports and continuation 
requests. 

7. Address your organization's 
adherence to CDC policies for securing 
approval for CDC sponsorship of 
conferences. If you plan to hold a 
conference, you must send a copy of the 
agenda to CDC's Grants Management 
Office. 

8. If you plan to use materials using 
CDC's name, send a copy of the 
proposed material to CDC's Grants 
Management Office for approval. 

Note: Send all reports to the Grants 
Management Specialist identified in the 
Section VII. Agency Contacts section of this 
announcement. 

VII. Agency Contacts 

For general questions about this 
announcement, contact: Centers for 
Disease Control and Prevention, 
Technical Information Management 
Section (TIMS), Procurement and Grants 
Office, 2920 Brandywine Road, Atlanta, 
GA 30341, Telephone: 770-488-2700. 

For program technical assistance, 
contact: Samuel Taveras, Team Leader, 
Centers for Disease Control and 
Prevention, National Center for HIV, 
STD, and TB Prevention, Division of 
HIV/AIDS Prevention, 1600 Clifton 
Road, Mailstop E-40, Atlanta, GA 
30333, Telephone: 404-639-5241, E- 
mail address: dhapcbapt@cdc.gov. 

For budget assistance, contact: Carlos 
Smiley, Grants Officer, Centers for 
Disease Control and Prevention, 
Procurement and Grants Office, 2920 
Brandywine Road, Room 3000, Atlanta, 
Georgia 30341-4146, Telephone: 770- 
488-2722, e-mail address: 
anx.3@cdc.gov. 

Dated: November 21, 2003. 
Edward Schultz, 

Acting Director. Procurement and Grants 
Office, Centers for Disease Control and 
Prevention. 

[FR Doc. 03-29806 Filed 11-26-03; 11:20 
am) 

BILLING COOE 4163-18-P 



DEPARTMENT OF HEALTH AND 
HUMAN SERVICES 

Centers for Disease Control and 
Prevention 

Human Immunodeficiency Virus (HIV) 
Prevention Projects for Community- 
Based Organizations 

Announcement Type: New. 
Funding Opportunity Number: 04064. 
Catalog of Federal Domestic 
Assistance Number: 93.939. 

Key Dates 

Letter of Intent Deadline: December 
22, 2003. 

Application Deadline: February 6, 
2004. 

I. Funding Opportunity Description 

Authority: This program is authorized 
under sections 301(a) and 317fk)(2) of the 
Public Health Service Act, [42 U.S.C. 241 and 
42 U.S.C. 247b(k)(2)], as amended. 

Purpose: The purpose of the program 
announcement is consistent with CDC's 
Government Performance and Results 
Act (GPRA) performance plan and the 
CDC goal to reduce the number of new 
HIV infections in the United States. 
Funds are available under this 
announcement for HIV prevention 
projects for Community-Based 
Organizations (CBOs). 

This program announcement i 
addresses the "Healthy People 2010" 
focus area of HIV Prevention. 

Measurable outcomes of this program 
will be in alignment with one (or more) 
of the following performance go'al(s) for 
the National Center for HIV, STD and 
TB Prevention (NCHSTP): 

• Decrease the number of persons at 
high risk for acquiring or transmitting 
HIV. 

• Increase the proportion of HIV- 
infected people who know they are 
infected. 

• Increase the proportion of HIV- 
infected people who are linked to 
appropriate prevention, care, and 
treatment services. 

• Strengthen the capacity nationwide 
to monitor the epidemic, develop and 
implement effective HIV prevention 
interventions, and evaluate prevention 
programs. 

The specific objectives of this 
announcement are to: 

• Reduce HIV transmission. 

• Increase the proportion of 
individuals at high risk for HIV 
infection who receive appropriate 
prevention services. 

• Roduce barriers to early diagnosis of 
HIV infection. 

• Increase the proportion of 
individuals at high risk for HIV 



infection who become aware of their 
serostatus. 

• Increase access to quality HIV 
medical care and ongoing prevention 
services for individuals living with HIV. 

• Address high priorities identified 
by the state or local HIV prevention 
Community Planning Group (CPG). 

• Complement HIV prevention 
activities and interventions supported 
by state and local health departments. 

Activities 

Throughout this program 
announcement, you will be asked to 
adapt and tailor CDC procedures, 
including Replicating Effective 
Programs (REP) and Diffusion of 
Effective Behavioral Interventions 
(DEBI) (see Attachment I). This program 
announcement and all attachments for 
this announcement are located on the 
CDC Web site http://www.cdc.gov. To 
view CDC procedures, program 
announcement attachments and other 
available technical assistance visit 
h ttp://www2a . cdc.gov/hivpra/ 
pa04064.html. Definitions for terms 
used frequently throughout the program 
announcement can be found in the 
Program Announcement Glossary (see 
Attachment II). The terms defined below 
are used frequently throughout the 
program announcement and are also 
included in the Glossary. 

For the purpose of this program 
announcement, an individual at high 
risk for HIV infection is someone who 
has had unprotected sex or has shared 
injecting equipment in a high- 
prevalence setting or with a person who 
is living with HIV. 

A high-prevalence setting is a 
geographic location or community with 
an HrV seroprevalence greater than or 
equal to one percent. 

An individual at very high risk for 
HIV infection is someone who (within 
the past six months) has: 

• Had unprotected sex with a person 
who is living with HIV. 

• Had unprotected sex in exchange 
for money or drugs. 

• Had multiple (greater than five) or 
anonymous unprotected sex or needle- 
sharing partners. 

OR 

• Been diagnosed with a sexually 
transmitted disease (STD). 

If CDC funds your CBO, you will be 
responsible for one or more of the 
following activities: 

1. Conducting targeted outreach and 
providing Health Education/Risk 
Reduction (HE/RR) for high-risk 
individuals. 

2. Conducting targeted outreach and 
providing Counseling, Testing, and 



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67567 



Referral (CTR) services for high-risk 
individuals. 

3. Implementing one or more of the 
interventions below: 

(a) Prevention for individuals living 
with HIV and their sex or injecting drug- 
using partners who are HIV negative or 
unaware of their HIV status. 

(b) Prevention for individuals at very 
high risk for HTV infection. 

(c) Partner Counseling and Referral 
Services (PCRS). 

You must also: 

4. Set a baseline level, annual targets, 
and five year overall target levels of 
performance for each core indicator 
identified by CDC [see Attachment HI 
for a description of program 
performance indicators). If your CBO is 
funded, CDC will meet with you within 
60 days to review the indicators. CDC 
will help you revise the indicators if 
necessary. If you fail to achieve your 
target levels of performance, CDC will 
work with you to improve performance. 
If your performance fails to improve, 
CDC may reduce the award or defund 
your program. 

5. Collect monitoring and evaluation 
data and report required data to CDC's 
Program Evaluation and Monitoring 
System (PEMS) (see Attachment rv for 
a description of PEMS). 

6. Refer individuals living with HIV to 
prevention services and medical care 
(including STD screening) if your CBO 
is unable to provide them directly. 

7. Refer individuals at very high risk 
for HIV infection to prevention services 
if your CBO is unable to provide them 
directly. 

8. Collaborate and participate in the 
HTV prevention community planning 
process with your local health 
department. 

9. Identify and address the capacity- 
building needs of your program and 
participate in mandatory CDC- 
sponsored training. 

In a cooperative agreement, CDC staff 
is substantially involved in program 
activities in addition to grant 
monitoring. If your CBO is funded 
under this announcement, CDC 
involvement will include: 

1. Providing assistance and 
consultation on program and 
administrative issues directly or through 
partnerships with health departments, 
national and regional minority 
organizations, contractors, and other 
national and local organizations. 

2. Working with you to assess your 
training needs and ensure that those 
needs are met. 

3. Disseminating current information, 
including best practices, in all areas of 
HIV prevention. 

4. Helping you to adopt effective 
intervention models through CDC 



procedures, workshops, conferences, 
and other written materials. 

5. Providing assistance and 
information on new rapid HIV testing 
technologies. 

6. Helping you establish partnerships 
with state and local health departments, 
community planning groups, and other 
groups who receive federal funding to 
support HIV/AIDS activities. 

7. Ensuring that successful prevention 
interventions, program models, and 
lessons learned are shared between 
grantees through meetings, workshops, 
conferences, newsletter development, 
Internet, and other avenues of 
communication. 

8. Monitoring your success in 
program and fiscal activities, protection 
of client privacy, and compliance with 
other organizational requirements. 

9. Developing program evaluation 
guidelines and protocols and program 
monitoring systems (including 
indicators) and protocols. 

10. Monitoring your progress toward 
achieving your target level of 
performance for each core indicator, and 
by working with you if you fail to 
achieve your target levels of 
performance. 

11. Providing assistance with required 
program indicators. 

II. Award Information 

Type of A ward: Cooperative 
Agreement. 

Fiscal Year Funds: 2004. 

Approximate Total Funding: 
$49,000,000. 

CDC anticipates the following 
distribution of funds: $12 million for 
targeted outreach and health education/ 
risk reduction; $14 million for targeted 
outreach and counseling, testing and 
referral services (CTR); and $23 million 
for prevention interventions. 

Approximate Number of Awards: 160. 

Approximate Average Award: 
$300,000. 

Floor of Award Range: $100,000. 

Ceiling of Award Range: $500,000. 

Anticipated Award Date: June 1, 2004. 

Budget Period Length: 12 months. 

Project Period Length: Up to 5 years. 

Continuation awards within an 
approved project period will be 
determined by the availability of funds 
and the best interest of the Federal 
Government. To be granted a 
continuation award, you must have: 

• Completed all recipient 
requirements. 

• Achieved your annual target levels 
of performance for each core indicator. 

• Submitted all required reports. 



III. Eligibility Information 

Eligible Applicants 

Applications may only be submitted 
by eligible CBOs, including faith-based 
CBOs. CBOs may apply under one of the 
following categories: 

Category A: Providing HIV prevention 
services to members of racial/ethnic 
minority communities who are at high 
risk for HTV infection. 

Category B: Providing HIV prevention 
services to members of groups at high 
risk for HIV infection regardless of their 
race/ethnicity. 

Other Eligibility Requirements 

To be eligible, your CBO must meet 
all criteria listed below. Your CBO must: 

A. Have tax-exempt status. 

B. Be located in the area(s) where 
services will be provided or have 
provided services in the area for at least 
three years. 

C. Have discussed the details of your 
proposed CTR program with the health 
department and have agreed to follow 
their guidelines for these services if 
your CBO provides them (see 
Attachment V for a list of requirements). 

D. Not be a government or municipal 
agency, private or public university or 
college, or private hospital. 

E. Not be a 501(c) (4) organization. 

Note: Title 2 of the United States Code 
section 1611 states that an organization 
described in section 501(c)(4) of the Internal 
Revenue Code that engages in lobbying 
activities is not eligible to receive federal 
funds constituting an award, grant, or loan. 

F. If applying under Category A, your 
CBO must: 

1. Have proof that 85 percent of the 
persons your CBO has served in each of 
the last three years were of racial/ethnic 
minority populations. 

2. Have provided HIV prevention 
services in each of the last three years 
to your proposed high-risk population. 

G. If applying under Category B, your 
CBO must: 

1. Have proof that over 50 percent of 
the persons your program has served in 
each of the last three years were from 
high-risk groups, regardless of their 
race/ethnicity. 

2. Have a program that has provided 
HIV prevention or care services in each 
of the last three years to your proposed 
target population, or have access to 
high-risk populations who do not have 
the services funded under this 
announcement available in their 
geographic area, such as transgender, 
drug-injecting women, and Native 
American populations. 

Note: All information submitted with your 
application is subject to verification during 
pre-decisional site visits. 



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This program announcement is 
limited to CBOs due to their credibility 
among individuals living with HIV and 
those at very high risk for HIV infection. 
CBOs have proven their ability to access 
hard-to-reach populations [e.g.. 
Intravenous Drug Users) that have 
traditionally suffered exclusion from 
mainstream interventions and agencies. 

Cost Sharing or Matching 

Matching funds are not required for 
this program. 

IV. Application and Submission 
Information 

Letter of Intent (LOI) 

Inform CDC that you plan to apply for 
funding by filling out the form found in 
Attachment VI. Please fax, mail, or e- 
mail your LOI to us by December 22, 
2003. You may also complete this form 
online at: http://www2a.cdc.gov/hivpra/ 
pa04064.html. 

Although a letter of intent is not 
required, this information will assist 
CDC in planning for the review process. 

Your LOI must contain: 

• Your organization name, address, 
executive director. 

• A description of your target 
population. 

• A statement of your intent to apply 
and category under which you are 
eligible to apply [e.g., Category A or 
Category B). 

Your application should not 
accompany your LOI. 

How to Obtain Application Forms: To 
apply for funding under this program 
announcement, use application form 
PHS 5161-1. Application forms and 
instructions are available on the CDC 
Web site, at the following Internet 
address: http://www.cdc.gov/od/pgo/ 
forminfo.htm. 

If you do not have access to the 
Internet, or if you have difficulty 
accessing the forms on-line, you may 
contact the CDC Procurement and 
Grants Office Technical Information 
Management Section (PGO-TIMj staff at 
770-488-2700. Application forms can 
be mailed to you. 

This program announcement provides 
final guidance on application format, 
content, and deadlines. If there are 
differences between the application 
form instructions and the program 
announcement, adhere to the guidance 
in the program announcement. 

You are required to have a Dun and 
Bradstreet Data Universal Numbering 
System (DUNS) number to apply for a 
»r;int or cooperative agreement from the 
federal government. The DUNS number 
is a nine-digit identification number, 
which uniquely identifies business 



entities. Obtaining a DUNS number is 
easy and there is no charge. To obtain 
a DUNS number, access http:// 
www.dunandbradstreet.com or call 1- 
866-705-5711. 

For more information, visit the CDC 
Web site at: http://www.cdc.gov/od/pgo/ 
funding/ pubcommt.htm. 

If your application form does not have 
a DUNS number field, please write your 
DUNS number at the top of the first 
page of your application, and/or include 
your DUNS number in your application 
cover letter. 

Application Content and Form of 
Submission 

You must submit a signed original 
and two copies of your application 
forms. 

You must include a project narrative 
with your application forms. Your 
narrative should address the activities 
that that your CBO will conduct over 
the entire five-year project period. 

Your narrative must be submitted in 
the following format: 

There is a maximum limit of 40 
single-spaced pages. If your narrative 
exceeds the page limit, only the first 40 
pages will be reviewed. 

• 12 point, unreduced font size. 

• 8.5 by 11 inch paper. 

• One-inch margins on each page. 

• Printed only on one side of paper. 

• Held together only by rubber bands 
or metal clips; not bound in any other 
way. 

This section of the program 
announcement defines program 
requirements. You must describe your 
plans to address each requirement. Your 
application will be reviewed based on 
your answers to the questions in 
subsections A through I. Please answer 
each question with complete sentences 
and provide all requested documents. If 
you fail to provide the required 
documents, your application will not be 
considered for review. 

This section also lists the core 
program indicators that will be used to 
measure your program's success. In your 
application, you are required to make an 
effort to report on the baseline level for 
each indicator, as well as projected one- 
year interim and five-year overall target 
levels of performance. When you apply 
for funding continuation, you will have 
the opportunity to revise your baseline, 
interim, and overall levels of 
performance, as specified in the 
guidance for completing your 
continuation application. In subsequent 
reports, you will report on the progress 
your CBO has made toward achieving 
your target level of performance for each 
corn indicator. 



When answering questions for 
subsections A-I, you must: 

• Label your application using the 
subsection title and name of the 
subsection [e.g., A. Eligibility) if 
applicable. 

• Use the abbreviation N/A (not 
applicable), if a question or subsection 
does not apply to your application. 

A. Eligibility 

Suggested length: ten pages or less. 

This section will not count toward the 
40 page limit of your application, but it 
will determine if you are eligible for 
funding. Place all documents requested 
in subsection A in Appendix A, labeled 
Proof of Eligibility. 

In your application, answer the 
following questions: 

1. Are you applying under Category 
A: Providing HIV prevention services to 
members of racial/ethnic minority 
communities who are at high risk for 
HIV infection or Category B: Providing 
HTV prevention services to members of 
groups at high risk for HIV infection 
regardless of their race/ethnicity? 

Note: For questions two through five, 
please provide documentation. Proof of 
location, history, and service must include at 
least one copy of a progress report describing 
services to the population served, a letter 
from one of your funding organizations, 
process monitoring data, service utilization 
data (which includes client characteristics), 
or a newspaper article. 

2. Does your CBO have a valid 
Internal Revenue Service (IRS) 501(c)(3) 
tax-exempt status or state proof of 
incorporation as a non-profit 
organization? If you answer yes, you 
must attach a copy of the letter from the 
IRS or a copy of your state proof of 
incorporation. If you answer no, you are 
not eligible to apply for funding under 
this program announcement. 

3. Are you located in the area in 
which services will be provided, or have 
you provided services in that area for at 
least three years? 

4. If your CBO is applying under 
Category A: 

(a) What proportion of the individuals 
your organization has served during 
each of last three years were members 
of racial/ethnic minority populations? 

(b) What evidence do you have that 
your CBO has provided HIV prevention 
services in each of the last three years 
to your proposed high-risk population? 

5. If your CBO is applying under 
Category B: 

(a) What evidence do you have that 
your program has provided HIV 
prevention or care services to your 
proposed target population during each 
of the last three years, or has access to 
high-risk populations who do not have 
services available in the area? 



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(b) What proportion of individuals 
served by your program during the last 
three years were from high-risk groups? 

6. Is your organization a governmental 
or municipal agency, a government- 
affiliated organization or agency [e.g., 
health department, school board, public 
hospital), or a private or public 
university or college? 

7. Is your organization included in the 
category described in section 501(c)(4) 
of the Internal Revenue Code of 1986 
that engages in lobbying activities? 

8. If you plan to offer HIV counseling 
and testing or partner counseling and 
referral services, have you discussed 
your proposed program with the health 
department? Have you agreed to follow 
the health department's guidelines for 
these services? Provide a letter from the 
health department addressing each item 
included in the sample letter. (Use 
Attachment VTI). 

9. Do you have voluntary counseling 
and testing, or care or treatment 
services, available onsite? If not, please 
provide a letter of intent to provide 
these services through another agency/ 
agencies. 

10. Is your organization applying as a 
single CBO, as a member of a coalition, 
or as a lead organization in a coalition, 
e.g., a collaborative contractual 
partnership? Please indicate which. 

11. Is your organization currently 
funded under CDC Program 
Announcement 99091, 99092, 99096, 
00023, 00100, 01033, 01163 or 03003? 
Please indicate which announcement(s). 

B. Justification of Need 

Suggested length: five pages. 

Note: Contact your health department to 
obtain HIV/AIDS statistics and HIV needs 
assessment data developed for the 
community planning process. This 
information will help you answer the 
questions in this section. 

In your application, please answer the 
following questions: 

1. What kind of services does your 
agency provide? 

2. Which organizations provide 
similar services in your area? 

3. Who is your proposed target 
population for this program 
announcement? Complete Attachment 
Vni and include it in your application 
as Appendix B. 

4. What are the behaviors that place 
your target population at high risk for 
HIV infection or for transmitting the 
virus? 

5. How has your proposed target 
population been affected by the HIV/ 
AIDS epidemic? (e.g., HIV incidence or 
prevalence, AIDS incidence or 
prevalence, ADDS mortality) 



6. What history do you have serving 
this population? (Please explain how 
long you have provided services, 
describe what kinds of services have 
been provided, describe the outcomes of 
services you provided, and describe 
your relationship with the community.) 

7. How do your staff members reflect 
your proposed target population? 
(Please describe, in aggregate, the 
characteristics of your key program staff 
in terms of experience working with the 
target population, gender, race/ 
ethnicity, HIV serostatus, area of 
behavioral risk expertise, or other 
relevant factors.) 

8. How will you involve the target 
population when planning and 
implementing your proposed services? 

9. How will your proposed activities 
meet the needs of your target population 
or improve available services? 

10. What services do you plan to 
provide under this program 
announcement? List all that apply in 
your application. 

(a) Targeted outreach and HE/RR to 
high-risk individuals. 

(b) Targeted outreach and CTR. 

(c) Prevention interventions for 
individuals living with HIV and their 
sex or injection drug-using partners. 

(d) Prevention interventions for 
individuals at very high risk for HIV 
infection. 

(e) Partner counseling and referral 
services. 

C. Targeted Outreach and Health 
Education/Risk Reduction for High-Risk 
Individuals 

Suggested length: five pages. 

1. If you are applying for targeted 
outreach and HE/RR services, you must 
conduct activities listed in sections F, G, 
H, and I. You must also: 

(a) Using CDC procedures including 
REP and DEBI, (see Attachment I), 
implement targeted strategies to 
increase the number of high-risk 
individuals who reduce their risk for 
HIV infection and consent to testing. 
Your strategies should aim to reach 
high-risk individuals who have not 
tested in the last six months or do not 
know their HTV serostatus. Activities 
should be conducted in a setting that is 
comfortable and accessible to your 
clients. Your strategies should also 
improve access to other local HIV 
prevention services. The following 
strategies will be supported: 

(1) Targeted outreach. 

(2) Individual-level interventions. 

(3) Small group-level interventions. 

(4) Referral networks. 

(b) Offer voluntary HIV counseling 
and testing to each individual identified 
through your program. If you do not 



conduct testing, you must establish a 
formal agreement with another agency/ 
agencies to provide testing. 

(c) Collect and report process and 
outcome monitoring data on the services 
you provide, including core 
performance indicators, as directed in 
the PEMS and the Evaluation Guidance. 

2. In your application, please answer 
the following questions: 

(a) How will you target your efforts to 
reach high-risk individuals who have 
not been tested in the last six months or 
do not know their HTV serostatus? 

(b) How will you identify and address 
barriers to accessing your target 
population? 

(c) How will you involve your target 
population when planning and 
implementing your proposed services? 

(d) How will you ensure that your 
activities will reach individuals at high 
risk for HIV infection who are unaware 
of their HIV serostatus or are not 
receiving prevention or care services? 

(e) How will you adapt and tailor 
relevant CDC procedures, including REP 
and DEBI, into your existing or 
proposed program? 

(f) How will you ensure access to 
voluntary HIV counseling and testing 
services? 

(g) What are your quality assurance 
strategies? 

(h) How will you train, support, and 
retain staff to conduct interventions? 

(i) How will you ensure client 
confidentiality? 

(j) How will you ensure that your 
services are culturally sensitive and 
relevant? 

(k) What are your baseline levels, 
projected one-year interim, and five- 
year overall target levels of performance 
for the following core program 
indicators? 

(1) The mean number of outreach 
contacts required to get one person with 
unknown or negative serostatus to 
access counseling and testing. 

(2) The proportion of persons who 
access counseling and testing from each 
of the following interventions: 
individual-level interventions and 
group-level interventions. 

(3) Proportion of persons that 
completed the intended number of 
sessions for each of the following 
interventions: Individual-level 
interventions and group-level 
interventions. 

D. Targeted Outreach and Counseling, 
Testing, and Referral Services (CTR) 

Suggested length: seven pages. 

1. If you are applying for targeted 
outreach and CTR, you must conduct 
activities listed in sections F, G, H and 
I. You must also: 



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(a) Use CDC procedures, including 
REP and DEBI, [see Attachment I] to 
provide counseling and voluntary HIV- 
testing services to high-risk individuals 
identified through your outreach 
strategies. CDC encourages recipients to 
use a Clinical Laboratory Improvement 
Amendments (CLIA) waived rapid test 
when appropriate and to process 
confirmatory tests at the state or local 
health department laboratory. (Research 
has shown that the use of rapid HTV 
tests increases the number of 
individuals who receive their results; 
and knowledge of HIV serostatus 
promotes safer behaviors.) Your 
proposed activities must meet all local, 
state, and federal requirements for HIV 
prevention counseling, testing, and 
referral services. If required by state 
regulations, provide a letter of intent 
from a physician stating his/her 
involvement in HIV-testing activities. 
This letter must address each item 
included in the sample letter (use 
Attachment VTI). 

Funding may be used to cover testing- 
related costs. You must share your plans 
with the health department and obtain 
a letter of support to be eligible for 
funding. 

(b) Provide post-test prevention 
counseling services for persons whose 
Hrv test results are negative, but who 
are at ongoing very high risk for HIV 
infection. You must also provide 
appropriate prevention interventions for 
this population. If you cannot provide 
these services directly, you must refer 
these individuals to appropriate 
prevention interventions. Contact your 
health department to identify available 
referral services in your area. 

(c) Provide post-test counseling 
services for persons whose HIV test 
results are positive. You must refer 
these individuals to the health 
department for Partner Counseling and 
Referral Services (PCRS). 

(d) Establish a formal agreement with 
a laboratory and provide a plan for 
ensuring training, oversight, quality 
assurance, and compliance with CLIA 
requirements and relevant state and 
local regulations applicable to waived 
testing, if you will be using a waived 
rapid HIV test. Obtain a CLIA Certificate 
of Waiver or approval to operate under 
that laboratory's CLIA certificate. 
Submit a letter of support from the 
laboratory. Include this document as 
Appendix C. 

(e) Implement strategies to reduce 
your target population's barriers to 
accessing CTR services (e.g., economic 
barriers, environmental barriers, 
cultural barriers, and social barriers). 

ffj Collect and report counseling and 
testing data, including core performance 



indicators, as directed in the PEMS and 
the Evaluation Guidance, and follow 
required health department reporting 
procedures. 

(g) Report confirmed HIV-positive 
tests to state and local health 
departments, following all rules and 
regulations regarding HIV and AIDS 
surveillance. 

2. In your application, please answer 
the following questions: 

(a) How will you ensure that 
counseling and testing activities will 
reach high-risk individuals who have 
not tested in the last six months or do 
not know their HTV serostatus? 

(b) How will you identify and address 
your target population's barriers to 
accessing voluntary HIV counseling and 
testing services? 

(c) How will you ensure that clients 
receive their test results, particularly 
clients who test positive? 

(d) How will you ensure that 
individuals with initial HIV-positive 
test results will receive confirmatory 
tests? (If you do not provide 
confirmatory HIV testing, you must 
provide a letter of intent or 
memorandum of agreement with an 
external laboratory documenting the 
process through which initial HIV- 
positive test results will be confirmed.) 

(e) How will you involve the target 
population when planning and 
implementing your proposed services? 

(f) How will you adapt, tailor, and 
implement relevant CDC procedures, 
including REP and DEBI? 

(g) What are your quality assurance 
strategies? 

(h) How will you train, support, and 
retain staff providing counseling and 
testing? 

(i) How will you ensure client 
confidentiality? 

(j) How will you ensure that your 
services are culturally sensitive and 
relevant? 

(k) What are your baseline levels and 
projected one-year interim and five-year 
overall target levels of performance for 
the following core program indicators? 

(1) Percent of newly identified, 
confirmed HIV-positive test results 
among all tests funded by CDC and 
reported by your organization. 

(2) Percent of newly identified, 
confirmed HIV-positive test results 
delivered to clients. 

E. Prevention Interventions 

Suggested length: seven pages. 

1 . If you are applying for funding to 
provide prevention services, you must 
conduct activities listed in sections F, G, 
H, and I. You must also: 

(a) Implement one or more of the 
interventions below using standard CDC 



procedures; including REP and DEBI 
(see Attachment I): 

(1) Prevention interventions for 
individuals living with HIV, and their 
sex and injection drug-using partners 
who are HIV negative or are unaware of 
their HIV serostatus. 

(2) Prevention interventions for 
seronegative individuals at very high 
risk for HTV infection. 

(3) Partner Counseling and Referral 
Services (PCRS). 

(b) If you want to provide PCRS, you 
must work with your health department 
and meet all local, state, and federal 
requirements for providing these 
services. Obtain a letter of agreement 
from your health department which 
must also state that your CBO meets all 
local, state, and federal requirements. 
This letter must address each item 
included in the sample letter. (Use 
Attachment VTI.) 

(c) Collect and report process and 
monitoring data on these services, 
including core performance indicators, 
as directed in the PEMS and Evaluation 
Guidance. 

2. In your application, for each service 
you plan to provide, please answer the 
following questions: 

(a) What are your proposed 
prevention interventions? 

(b) How will you identify and offer 
services to individuals living with HIV, 
and their sex and injection drug-using 
partners who are HIV negative or who 
do not know their HPV status? 

(c) How will you identify and offer 
services to individuals at very high risk 
for HIV infection? 

(d) Where will you provide 
prevention services? (Please describe 
the setting.) 

(e) How will you maintain and retain 
individuals in your prevention 
intervention(s)? 

(f) How will you coordinate 
prevention services with other case 
management and/or treatment providers 
for individuals living with HIV? 

(g) How will you ensure that 
prevention services do not duplicate 
services provided by the Ryan White 
Care Act program? 

(h) How will you address barriers 
related to partner counseling and 
referral services? 

(i) What are the qualifications of staff 
providing prevention services? 

(j) How will you involve the target 
population when planning and 
implementing your proposed services? 

(k) How will you adapt, tailor, and 
implement relevant CDC procedures, 
including REP and DEBI? 

(1) What are your quality assurance 
strategies? 



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(m) How will you train, support, and 
retain staff to provide these 
interventions? 

(n) How will you ensure services are 
culturally sensitive and relevant? 

(0) How will you ensure client 
confidentiality? 

(p) What are your baseline levels, 
projected one-year interim, and five- 
vear target levels of performance for the 
following core program indicators 
relevant to your program: 

(1) Proportion of persons living with 
HIV and their sex and injection drug- 
using partners who are HIV negative or 
who do not know their HIV status that 
completed the intended number of 
sessions for each of the prevention 
interventions supported by this program 
announcement. 

(2) Proportion of persons at very high 
risk for HIV infection who completed 
the intended number of sessions for 
each of the prevention interventions 
supported by this program 
announcement. 

(3) Percent of HIV infected persons 
who, after a specified period of 
participation in each of the prevention 
interventions supported by the program 
announcement, report a reduction in 
sexual or drug-using risk behaviors or 
maintain protective behaviors with 
seronegative partners or with partners of 
unknown status. 

(4) Percent of contacts with unknown 
or negative serostatus receiving an HIV 
test after PCRS notification. 

(5) Percent of contacts with a newly 
identified, confirmed HIV-positive test 
among contacts who are tested. 

(6) Percent of contacts with a known, 
confirmed HIV-positive test among all 
contacts. 

F. Evaluation and Monitoring 
Intervention Activities 

Suggested length: five pages. 

1. You must: 

(a) Collect and report client-level data. 

(b) Collect and report standardized 
process and outcome monitoring data 
consistent with CDC requirements. 

(c) Enter and transmit data for CDC- 
funded services on CDC's browser-based 
system or describe plans to make a local 
system compatible with CDC's system. 
(There is a description of PEMS in 
Attachment IV.] 

(d) Collect and report data consistent 
with CDC requirements to ensure data 
quality and security and client 
confidentiality. 

(e) Collaborate with CDC to assess the 
impact of HIV prevention activities and 
participate in special projects upon 
request. 

2. In your application, please describe 
vour: 



(a) Current system of data collection 
and methods for reporting HIV 
prevention activities including data 
system specifications and data 
management information systems. 

(b) Capacity to collect and report 
client-level data for HIV prevention 
services and the effect of those services 
on client HIV risks and health service 
utilization. 

(c) Plans to identify and address 
barriers and facilitators to the collection 
of client-level demographic and 
behavioral characteristics. 

(d) Plans to ensure that data quality 
and security are consistent with CDC 
requirements and guidelines. 

(e) Willingness to collaborate with 
CDC in the design and implementation 
of other evaluation projects. 

(f) Technical assistance needs to meet 
evaluation and monitoring 
requirements. 

(g) Baseline level, one-year interim, 
and five-year overall target levels of 
performance for the following core 
indicator: proportion of client records 
with the CDC-required demographic and 
behavioral risk information. 

G. Referral Activities 

Suggested length: four pages. 

1. For services not available through 
your organization, you must: 

(a) Collaborate with other agencies to 
increase the number of persons who 
receive comprehensive services 
including prevention, testing, medical 
care, mental health, and drug abuse 
treatment. 

(b) Develop a formal agreement such 
as a memorandum of understanding 
with each collaborating agency serving 
persons identified through your 
program within six months of funding. 

(cj Track referral activities and their 
outcomes. You must document the type 
of referral [e.g. mental health, housing), 
date of referral, and outcome of referral 
(such as completion of first 
appointment). 

(d) Collect and report data on 
referrals, including core performance 
indicators, as directed in the PEMS and 
Evaluation Guidance. 

2. In your application, you must: 

(a) Describe your plans to develop a 
referral network to ensure that clients 
identified through your program have 
access to comprehensive services 
including access to primary care, life- 
prolonging medications, and essential 
support services that will maintain HIV- 
positive individuals in systems of care. 

(b) Provide documentation of any 
formal agreements with providers and 
other agencies where your clients may 
be referred. 

(c) Specify baseline levels, projected 
one-year interim, and five-year overall 



performance levels for the following 
core indicator: The mean number of 
outreach contacts required to get a 
person living with HIV, and their sex 
and injection drug-using partners, or an 
individual at very high risk for HIV 
infection, to access referrals made under 
this program announcement. 

H. Collaboration and Coordination With 
the HIV Prevention Community 
Planning Process and Local Health 
Department 

Suggested length: three pages. 

1. You must: 

(a) Collaborate and coordinate 
activities with the HIV prevention CPG 
and local health department. 
Collaboration activities may include 
participating in the needs assessment 
process, reviewing and commenting on 
plans, presenting an overview of your 
project activities to the CPG in their 
jurisdiction and making clients 
available for focus groups and other 
planning activities. Coordination 
activities may include sharing progress 
reports, program plans, and monthly 
calendars with state and local health 
departments, CPGs, and other 
organizations and agencies involved in 
HIV prevention activities serving your 
target population. 

lb) Participate in the HIV prevention 
community planning process. 
Participation may include involvement 
in workshops, attending meetings, 
serving as a member of the CPG, and 
becoming familiar with and utilizing 
information from the community 
planning process, such as the 
epidemiologic profile, needs assessment 
data, and intervention strategies. 
Membership in the CPG is not required, 
and it is determined by the group's 
bylaws and selection criteria. 

2. In your application, describe your 
plans to: 

(a) Participate, collaborate, and 
coordinate with the HIV prevention 
CPG. 

(b) Participate, collaborate, and 
coordinate with the local health 
department. 

(c) Participate in the HIV prevention 
community planning process. 

I. Capacity Building 

Suggested length: four pages. 
1. You must: 

(a) Conduct a capacity-building needs 
assessment. 

(b) Develop a comprehensive 
capacity-building plan based on the 
outcomes of the needs assessment. 

(c) Share any new CBA needs that 
develop during the project period with 
your project officer. 

(d) Attend a grantee orientation for 
administrative and programmatic staff. 



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(e) Participate in any mandatory 
training conducted or sponsored by 
CDC. 

If) Ensure that your CBO's financial 
manager attends a CDC-sponsored 
financial training. If the financial 
manager leaves your agency, his/her 
replacement must attend training within 
six months. 

2. In your application, please answer 
the following questions: 

(a) What are your immediate, 
intermediate and long term CBA needs; 
and how do you plan to address them? 

(b) How do you plan to share any new 
CBA needs that develop during the 
project period with your project officer? 

J. Guidance on Use of Funds 

You must consider the following 
funding restrictions when you are 
creating your project budget: 

• Funds may be used to hire 
contractors or support coalition partners 
to strengthen program activities. CDC 
encourages you to develop coalitions 
with other prevention providers, 
medical providers, and health 
departments to implement your 
proposed program; however, your CBO, 
not the contract organization(s) or the 
coalition partner(s), must conduct the 
largest portion of the activities 
(including managing the program and 
activities) funded by this award. 

• Funds cannot be used to provide 
medical or substance abuse treatment. 

If you are requesting indirect costs in 
your budget, you must include a copy 
of your negotiated indirect cost rate 
agreement. If your indirect cost rate is 
a provisional rate, the agreement must 
be less than 12 months of age. 

For budget guidance, visit the CDC 
Web site http://www.cdc.gov/od/pgo/ 
funding/budgetguide.htm. 

Submission Date, Time, and Address 

LOI Deadline Date: December 22, 
2003. 

LOI Submission Address: Submit your 
LOI by express delivery service, or e- 
mail to: William Bancroft, Public Health 
Analyst, CDC, NCHSTP, DHAP, IR, 1600 
Clifton Road, MS E58, Atlanta, GA 
30333, Pa04064@cdc.gov. 

Application Deadline Date: February 
6, 2004. 

Application Submission Address: 
Submit your application by mail or 
express delivery service to: Technical 
Information Management — PA# 04064, 
CDC Procurement and Grants Office, 
2920 Brandywine Road, Atlanta, GA 
30341. 

Explanation of Deadlines: 
Applications must be received in the 
CDC Procurement and Grants Office by 
4 p.m. Eastern Time on the deadline 



date. If you send your application by the 
United States Postal Service or 
commercial delivery service, you must 
ensure that the carrier will be able to 
guarantee delivery of the application by 
the closing date and time. If CDC 
receives your application after closing 
due to: (l) carrier error, when the carrier 
accepted the package with a guarantee 
for delivery by the closing date and 
time, or (2) significant weather delays or 
natural disasters, you will be given the 
opportunity to submit documentation of 
the carrier's guarantee. If the 
documentation verifies a carrier 
problem, CDC will consider the 
application as having been received by 
the deadline. 

If your application does not meet the 
submission deadline, it will not be 
eligible for review and will be 
discarded. You will be notified that you 
did not meet the submission 
requirements. 

CDC will not be sending postcards to 
confirm application receipt. Please 
contact your mail carrier to confirm 
delivery. If you still have questions, 
contact the PGO-TIM staff at 770-488- 
2700. Before calling, please wait two to 
three days after the application 
deadline. This will allow time for the 
applications to be processed and logged. 

Intergovernmental Review of 
Applications: Executive Order 12372 
does apply to this program. 

V. Application Review Information 

Review Criteria: You are required to 
provide measures of effectiveness that 
will demonstrate the accomplishment of 
the various identified objectives of the 
cooperative agreement. Measures of 
effectiveness must relate to the 
performance goals stated in the 
"Purpose" section of this 
announcement. Measures must be 
objective and quantitative, and must 
measure the intended outcome. These 
measures of effectiveness must be 
submitted with the application and will 
be an element of evaluation. 

There are 2 steps to the evaluation 
process. 

Step One 

In the first step of the evaluation 
process, your application will be 
evaluated based on each item referenced 
in Section IV., entitled, "Application 
and Submission Information." Your 
application will be evaluated by an 
independent review panel assigned by 
CDC. The panel will assign your 
application a score using scored 
evaluation criteria as specified in 
Section V., entitled, "Application 
Review Information," and based on your 
responses to the questions in Section 



IV., entitled, "Application and 
Submission Information" beginning 
with B. Justification of Need. Your 
application will be ranked based on this 
score. The highest-ranked applications 
will be considered for a pre-decisional 
site visit (Step two). 

Step Two 

The second step of the review process 
is conducted via pre-decisional site 
visits which are worth 100 points. To be 
considered for funding, you must score 
at least 70 points during this process. If 
you fail to reach 70 points, your CBO 
will be disqualified. CDC will invite 
health department staff to participate in 
the site visit. 

Criteria for Step One: Application 
Review 

Your application will be evaluated on 
the following criteria: 

A. Eligibility (not scored) 

This section of your application will 
be reviewed to determine if you are 
eligible for funding. 

B. Justification of Need (200 points) 

This section of your application will 
be scored based on your description of: 

• The target population's needs. 

• How your proposed intervention 
meets the needs of the jurisdiction's HIV 
Prevention Comprehensive Plan. 

• Your experience and credibility in 
working with the proposed target 
population. 

C. Targeted Outreach and Health 
Education/Risk Reduction for High-Risk 
Individuals (150 points) 

This section of your application will 
be scored based on your target levels of 
performance for each core indicator and 
your plans to: 

• Increase the number of persons at 
high risk for HIV infection who learn 
their HIV serostatus. 

• Identify persons at high risk for HIV 
infection. 

• Identify and address your target 
population's barriers to accessing HE/ 
RR. 

• Involve the target population when 
planning and implementing your 
program(s). 

• Adapt and tailor CDC procedures, 
including REP and DEBI. 

• Offer voluntary HIV counseling and 
testing to each individual reached by 
your program. 

• Ensure that individuals who 
consent to HIV testing receive a test 
either through your CBO or via referral. 

• Develop, implement, and maintain 
quality assurance strategies. 

• Train, support, and retain staff. 



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• Ensure client confidentiality. 

• Ensure cultural sensitivity and 
relevance of your interventions. 

D. Targeted Outreach and Counseling, 
Testing, and Referral Services (CTR) 
(150 points) 

This section of your application will 
be scored based on your target levels of 
performance for each core indicator and 
your plans to: 

• Identify high-risk individuals who 
have not tested within the past six 
months or do not know their HIV 
serostatus for voluntary counseling and 
testing. 

• Identify and address your target 
population's barriers to accessing 
counseling and testing services. 

• Ensure clients receive their test 
results. 

• Ensure confirmatory testing for 
positive initial test results. 

• Involve your target population 
when planning and implementing your 
program(s). 

• Adapt and tailor CDC procedures, 
including REP and DEBI, to your 
existing or proposed services. 

• Develop, implement, and maintain 
quality assurance strategies for 
counseling, testing, and referral 
services. 

• Train, support, and retain staff. 

• Ensure client confidentiality. 

• Ensure cultural sensitivity and 
relevance of your interventions. 

E. Prevention Interventions (175 points) 

This section of your application will 
be scored based on your proposed target 
levels of performance for each core 
indicator and your plans to: 

• Identify and offer services to 
individuals living with HIV, and their 
sex and injection drug-using partners 
who are HTV negative, or who do not 
know their HIV status. 

• Identify and offer services to 
individuals at very high risk for HIV 
infection. 

• Coordinate prevention services with 
other case management and/or 
treatment providers for individuals 
living with HIV. 

• Ensure that prevention services do 
not duplicate services provided by the 
Ryan White Care Act program. 

• Identify and address barriers to 
retaining persons in interventions. 

• Identify and address barriers to 
conducting your proposed prevention 
interventions. 

• Meet all local, State, and Federal 
requirements for HIV prevention 
services. 

• Involve your target population 
when planning and implementing your 
program(s). 



• Adapt and tailor relevant CDC 
procedures, including REP and DEBI, to 
your existing services or proposed 
program. 

• Develop, implement, and maintain 
quality assurance strategies for 
prevention interventions. 

• Train, support, and retain staff. 

• Ensure client confidentiality. 

• Ensure cultural sensitivity and 
relevance of the prevention 
interventions. 

F. Evaluation and Monitoring 
Intervention Activities (100 points) 

This section of your application will 
be scored based on your target levels of 
performance for each core indicator and 
the description of your: 

• Current data collection and 
reporting systems. 

• Capacity to collect and report 
client-level data. 

• Plans to identify and address 
barriers to client-level data. 

• Plans to ensure data quality and 
security. 

• Willingness to collaborate with CDC 
in special evaluation and monitoring 
projects. 

• Technical assistance needs to meet 
evaluation and monitoring 
requirements. 

G. Referral Activities (100 points) 

This section of your application will 
be scored based on your baseline and 
projected target levels of performance 
for each core indicator and your plans 
to: 

• Identify and collaborate with other 
agencies to ensure access to 
comprehensive services, including 
access to primary care, life-prolonging 
medications, and essential support 
services that will maintain HIV-positive 
individuals in systems of care. 

• Track referral activities and 
outcomes of these activities. 

• Develop formal agreements with 
your network of providers. 

H. Collaboration and Coordination With 
the HTV Prevention Community 
Planning Process and Local Health 
Department (75 Points) 

This section of your application will 
be scored based on your plans to: 

• Collaborate and coordinate 
activities with the HIV prevention 
Community Planning Group (CPG). 

• Collaborate and coordinate 
activities with the health department. 

• Participate in the HrV prevention 
community planning process. 

I. Capacity Building (50 points) 

This section of your application will 
be scored based on your plans to: 



• Conduct a comprehensive capacity- 
building needs assessment of your 
agency. 

• Work with CDC-coordinated 
capacity-building programs. 

Step Two: Pre-Decisional Site Visit 

The following areas will be evaluated 
during the visit: 

A. Proposed Program (250 points) 

The purpose of this section is to 
assess your CBO's ability to effectively 
implement your proposed HIV 
prevention interventions. Your score 
will be based on: 

• Your implementation of CDC 
protocols and procedures, including 
REP and DEBI. 

• Your one-year and five-year overall 
target levels of performance 

• How your target population reflects 
the priorities identified in the HrV 
Prevention Comprehensive Plan. 

• How your interventions reflect the 
needs identified in the your 
jurisdiction's HTV Prevention 
Comprehensive Plan. 

B. Programmatic Infrastructure (200 
points) 

The purpose of this section is to 
assess your CBO's experience and 
ability to identify and address the needs 
of your proposed target population. This 
section will also assess your ability to 
effectively and efficiently implement 
your proposed activities. Your score 
will be based on your CBO's: 

• Organizational structure and 
planned collaborations. 

• Experience in developing and 
implementing effective and efficient 
HIV prevention strategies and activities. 

• Experience with governmental and 
non-governmental organizations, 
including other national agencies or 
organizations, state and local health 
departments, CPGs, and state and local 
non-governmental organizations that 
provide HIV prevention services. 

• Ability to secure meaningful input 
and representation from members of the 
target population(s). 

• Ability to provide culturally 
competent and appropriate services that 
respond effectively to the characteristics 
of the target population (characteristics 
may include cultural, gender, sexual 
orientation, HIV serostatus, race/ 
ethnicity, age, environmental, social, 
and linguistic characteristics). 

• Ability to adequately staff your 
program. 

• Ability to collect and report process 
and monitoring data on services 
provided and use them to plan future 
interventions and improve available 
services. 



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C. Organizational Infrastructure (150 
points) 

The purpose of this section is to 
assess your CBO's ability to effectively 
and efficiently sustain your proposed 
program. Your score will be based on 
your CBO's: 

• Organizational bylaws, mission, 
and vision. 

• Composition, role, experience, and 
involvement of the board of directors in 
administering the agency. 

• Current fiscal systems to track 
available funding. 

• Personnel process and procedures. 

• Organizational protocols and 
procedures e.g., security, 
confidentiality, and grievances. 

• Organizational capacity for 
fundraising. 

D. Health Department Review (100 
points) 

The purpose of this section is to 
gather feedback on your proposed 
program plan from the health 
department. Your score will be based on 
the health department's review of your: 

• Review of the program plan (e.g., 
proposed target population, proposed 
intervention(s), number of persons to be 
served, and service location) and your 
consistency with the HIV Prevention 
Comprehensive Plan. 

• Rating of past experience with 
state/city-funded programs. 

• Letter of support or non-support for 
funding from the health department, 
addressed to CDC. 

CDC's Procurement and Grants Office 
(PGO) will conduct a Recipient 
Capability Assessment (RCA) to 
evaluate your CBO's ability to manage 
CDC funds. This assessment will be 
conducted by either PGO staff or 
another selected agency. 

Review and Selection Process 

In addition to your application 
content score and the outcome of your 
pre-decisional site visit, the following 
factors may affect the funding decision: 
Preference for funding will be given to 
ensure that: 

• Funded CBOs are balanced in terms 
of targeted racial/ethnic minority 
groups. (The number of funded CBOs 
serving each racial/ethnic minority 
group may be adjusted based on the 
burden of infection in that group as 
measured by HIV or AIDS reporting.) 

• Funded CBOs are balanced in terms 
of targeted risk behaviors. (The number 
of funded CBOs serving each risk group 
may be adjusted based on the burden of 
infection in that group as measured by 
HIV or AIDS reporting.) 

• Funded CBOs are balanced in terms 
of geographic distribution. 



(Consideration will be given to both 
high and lower prevalence areas; the 
number of funded CBOs may be 
adjusted based on the burden of 
infection in the jurisdiction as measured 
by HIV or AIDS reporting.) 

• Funded CBOs are balanced in terms 
of targeted gender. (The number of 
funded CBOs serving each gender group 
may be adjusted based on burden of 
infection in that group as measured by 
HIV or AIDS reporting.) 

• Funding opportunities are available 
for faith-based CBOs and CBOs serving 
rural areas, incarcerated individuals, or 
high risk populations who do not have 
the services funded under this 
announcement available in their 
geographic area. 

VI. Award Administration Information 

Award Notices: If your CBO is funded, 
you will receive a Notice of Grant 
Award (NGA) from the CDC 
Procurement and Grants Office. The 
NGA shall be the only binding, 
authorizing document between the 
recipient and CDC. The NGA will be 
signed by an authorized Grants 
Management Officer, and mailed to the 
recipient fiscal officer identified in the 
application. 

Administrative and National Policy 
Requirements: 45 CFR part 74 and 92. 

For more information on the Code of 
Federal Regulations, see the National 
Archives and Records Administration at 
the following Internet address: http:// 
www.access.gpo.gov/nara/cfr-table- 
search.html. 

The following additional 
requirements apply to this project: 

• AR^i HIV/AIDS Confidentiality 
Provisions 

• AR-5 HIV Program Review 
Panel Requirements 

• AR-7 Executive Order 12372 

• AR-8 Public Health System 
Reporting Requirements 

• AR-9 Paperwork Reduction Act 
Requirements 

• AR-10 Smoke-Free Workplace 
Requirements 

• AR-11 Healthy People 2010 

• AR-1 2 Lobbying Restrictions 

• AR-14 Accounting System 
Requirements 

• AR-1 5 Proof of Non-Profit Status 
Additional information on these 

requirements can be found on the CDC 
Web site at the following Internet 
address: http://www.cdc.gov/od/pgo/ 
funding/ ARs. htm. 

Reporting Requirements 

1. You must provide CDC with an 
original, plus two copies of the 
following reports: 

(a) Your interim progress report, no 
later than February 15 of each year. The 



progress report will serve as your non- 
competing continuation application, 
and must contain the following 
elements: 

(1) Current budget period activities 
objectives. 

(2) Current budget period financial 
progress. 

(3) New budget period proposed 
program activity objectives. 

(4) Detailed line-item budget and 
justification. 

(5) Baselines and target levels of 
performance for core and optional 
indicators. 

(6) New budget period proposed 
program activities. 

(7) Additional requested information. 

(b) The second semi-annual report 
will be due August 30 of each year. 
Additional guidance on what to include 
in this report may be provided 
approximately three months before the 
due date. It should include: 

(1) Baseline and actual level of 
performance on core and optional 
indicators. 

(2) Current budget period financial 
progress. 

(3) Additional requested information. 

(c) Financial status report, no more 
than 90 days after the end of the budget 
period. 

(d) Final financial and performance 
reports, no more than 90 days after the 
end of the project period. 

(e) Data reports of agency, financial, 
and HIV interventions including, but 
not limited to, HIV individual and 
group level; PCM; outreach; CTR; and/ 
or partner CTR services are required 45 
days after the end of each quarter or as 
specified in the most recent evaluation 
guidance. Project areas may request 
technical assistance. Submit data to the 
Program Evaluation Research Branch 
electronically, and then send an 
electronic notification of your data 
submission to the Grants Management 
Specialist listed in the "Agency 
Contacts" section of this announcement. 

2. Submit any newly developed 
public information resources and 
materials to the CDC National 
Prevention Information Network 
(formerly the AIDS Information 
Clearinghouse) so that they can be 
incorporated into the current database 
for access by other organizations and 
agencies. 

3. HIV Content Review Guidelines, (a) 
Submit the completed Assurance of 
Compliance with the Requirements for 
Contents of AIDS-Related Written 
Materials Form (CDC form— 0.1113) 
with your application as Appendix D. 
This form lists the members of your 
program review panel. The form is 
included in your application kit. The 



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67575 



current Guidelines and the form may be 
downloaded from the CDC Web site: 
h ttp ://www. cdc.gov I o d/pgo/ 
forminfo.htm. Please include this 
completed form with your application. 
This form must be signed by die Project 
Director and authorized business officer. 

(b) You must also include approval by 
the relevant review panel of any CDC- 
funded HTV educational materials that 
you are currendy using by the relevant 
review panel. Use the enclosed form, 
"Report of Approval". If you have 
nothing to submit, you must complete 
the enclosed form "No Report 
Necessary". You must include either the 
"Report of Approval" or "No Report 
Necessary" with all progress reports and 
continuadon requests. 

(c) Use a Web page notice if your Web 
site contains HIV/ AIDS educational 



information subject to the CDC content 
review guidelines. 

4. Adhere to CDC policies for securing 
approval for CDC-sponsored 
conferences. If you plan to hold a 
conference, you must send a copy of the 
agenda to CDC's Grants Management 
Office. 

5. If you plan to use materials using 
CDC's name, send a copy of the 
proposed material to CDC's Grants 
Management Office for approval. 

VII. Agency Contacts 

For general questions about this 
announcement, contact: Technical 
Informadon Management Secdon, CDC 
Procurement and Grants Office, 2920 
Brandywine Road, MS K14, Atlanta, GA 
30341, Telephone: 770-^188-2700. 



For program technical assistance, 
contact: Samuel Martinez, M.D., Health 
Scientist, CDC, NCHSTP, DHAP, IRS, 
1600 Clifton Road, MS E58, Atlanta, GA 
30333, Telephone: 404-639-5219, E- 
mail: Sbm5@cdc.gov. 

For budget assistance, contact: Carlos 
Smiley, Grants Management Officer, 
CDC Procurement and Grants Office, 
2920 Brandywine Road, MS K14, 
Atlanta, GA 30341, Telephone: 770- 
488-2722, E-mail: anx3@cdc.gov. 

Dated: November 21, 2003. 
Edward Schultz, 

Acting Director, Procurement and Grants 
Office, Centers for Disease Control and 
Prevention. 

[FR Doc. 03-29807 Filed 11-26-03; 11:20 
am] 

SILLING CODE 4163-18-P 



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57 



58 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix F 

Sample Memorandum of Understanding 



CAEAR Foundation (2005). Opening Doors: Linkages Training Manual. 
Linkage Worksheet #6: Your Sample MOU. www.caear.org/docs/work- 
sheet6.pdf. Used with permission from the CAEAR Foundation. 



HIV/AIDS: Building Capacity to Berter Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



59 



Linkage Worksheet 6 



COMMUNITIES ADVOCATING 
EMERGENCY AIDS RELIEF 

CAEAR 



page I 



C O A L I T I 



FOUNDATION 



Your Sample MOU 



60 



Use this worksheet as a template for what an MOU could look like between your 
agency and another collaborating partner. 



Memorandum of Understanding 

between 

Crestview HIV Care Center and Creekside Nutrition Center 

YOUR AGENCY REFERRAL AGENCY 

This agreement is entered between 

Crestview HIV Care Center and Creekside Nutrition Center 

YOUR AGENCY REFERRAL AGENCY 

Describe your mission: 

Crestview HIV Care Center provides medical care and case management 
services for people in all stages of HIV disease. 

Describe the other agency's mission: 

Creekside Nutrition Center distributes food and cooked meals to people 
with limited financial resources and those who are too ill to prepare 
their own meals. 



Summary 

Crestview HIV Care Center and Creekside Nutrition Center 

YOUR AGENCY . REFERRAL AGENCY 

Agree to jointly collaborate on the HIV nutrition project an effort to increase linkages between 

NAME OF PROJECT 

HIV care providers and providers of food in Mountain Valley. 

FACILITIES/LOCATION 

As partners, 

Crestview HIV Care Center and Creekside Nutrition Center agree to 

YOUR AGENCY REFERRAL AGENCY 

work together to provide people with HIV/AIDS who can not afford food 
or are unable to cook for themselves with food and prepared meals. 

HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



COMMUNITIES ADVOCATING 
EMERGENCY AIDS RELIEF 

CAE AR 



FOUNDATION 



Linkage Worksheet 6 



page 2 



Your Sample MOU 
continued 



The parties propose to serve 

People with HIV/AIDS in Mountain Valley whose nutritional needs are not 
being met. 

DESCRIBE NATURE OF COLLABORATION 



Responsibilities 

Crestview HIV Care Center wil 

YOUR AGENCY 



Creekside Nutrition Center wil 

REFERRAL PARTNER 



Assess all clients nutritional needs and 
their resources to meet those needs 

Identify clients whose nutritional needs 
are not being met and provide them with 
information about the services of Creekside 
Nutrition Center 

Contact Creekside Nutrition Center's intake 
coordinator and schedule an intake 
appointment for each referred client 

Comply with all appropriate local, state, 
or Federal laws and regulations 
(Always include the compliance responsibility.) 

Conduct intake sessions for all clients 
referred from Crestview HIV Care Center 

Develop a nutrition plan for each client 
and begin providing appropriate food and 
meal services 

Provide appropriate Crestview HIV Care 
Center case manager with information on 
services provided to each client. 

Refer clients with HIV who need medical 
and support services to Crestview HIV Care 
Center's intake coordinator and schedule an 
appointment for them as necessary 

Comply with all appropriate local, state, 
or Federal laws and regulations 
(Always include the compliance responsibility.) 



61 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Linkage Worksheet 6 



COMMUNITIES ADVOCATING 
EMERGENCY AIDS RELIEF 

CAE AR 



page 3 



Your Sample MOU 
foundation continued 



COALITION 



62 



Time-line & Duration 

This MOU shall remain in place from January 1. 2003 until December 31. 2 003 

STARTING DATE ENDING DATE 

unless modified in writing before that date. The MOU may be extended for Six months 

LIST TIME PERIOD IN MONTHS OR YEARS 

Termination 

This MOU may be terminated in whole or in part by either party without cause. The MOU will be 
deemed to be terminated 30 days after written notice of intent to terminate has been received by 
the other party.This notification must include the reason for termination. This MOU will terminate 
automatically if (list contingencies) 

Either agency ceases operations 

In the event of termination, all required reports will be completed through the end of the 
agreement period. 



Personnel 

Staff governed by this MOU include (list staff titles/positions) 
Crestview HIV Care Center Case managers 

Intake coordinator 

Creekside Nutrition Center Intake coordinator 

Points of contact for communication on this MOU will be 

John Smith, case management director 
contact for your agency 

Susan Wilson, intake coordinator 
contact for collaborating agency 

HIV/AII)S: Building Capacity to Bettei Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Linkage Worksheet 6 



COMMUNITIES ADVOCATING 
EMERGENCY AIDS RELIEF 

CAEAR 



FOUNDATION 



page 4 



Your Sample MOU 
continued 



Reporting 

Report will be submitted to each agency on a quarterly basis. 

FREQUENCY 

Crestview HIV Care Center will provide 

YOUR AGENCY 

the total number of clients referred to Creekside Nutrition Center's 
intake coordinator 



Creekside Nutrition Center will provide 

OTHER AGENCY 

the number of intakes it performed for Crestview HIV Care Center clients, 
the number deemed eligible for services, and the number that enrolled. 



Finances 

LIST FINANCIAL ARRANGEMENTS. IF ANY. IF NONE, STATE SO. 



Neither party will compensate the other for services performed 



Confidentiality 

DESCRIBE HOW CONFIDENTIALITY WILL BE PROTECTED BY EACH PARTY. 



Both Crestview HIV Care Center and Creekside Nutrition Center have 
confidentiality policies (attached) governing client-related information 
and client files and both will adhere to their policies. Referrals will 
be made via telephone, but no names will be left on voicemails or sent 
via email. Quarterly reports will only contain aggregate numbers and no 
names . 

Crestview HIV Care Center's case management director and Creekside 
Nutrition Center's intake coordinator will meet quarterly. 

Clients names shall remain confidential as required by state and local law. 



63 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



Linkage Worksheet 6 



COMMUNITIES ADVOCATING 
EMERGENCY AIDS RELIEF 

CAE AR 



page 5 



C O A L I T I 



FOUNDATION 



Your Sample MOU 
continued 



Communication 

Andre Jackson, Executive Director, Crestview HIV Care Center and 

YOUR AGENCY 

Tammy Mills, Executive Director, Creekside Nutrition Center 

COLLABORATING AGENCY 

will participate in meetings on a quarterly basis. 

FREQUENCY 

These meetings will provide an opportunity to assess the referral linkages, review referral data 
and suggest necessary improvements. Other parties are also invited to participate in these 
meetings, as needed. 



Signatures 



YOUR AGENCY'S EXECUTIVE DIRECTOR 



OTHER AGENCY'S EXECUTIVE DIRECTOR 



LIST EXACT TITLE 



LIST EXACT TITLE 



YOUR AGENCY NAME 



OTHER AGENCY NAME 



64 



I II WAN )S: Building ( Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix G 



Ryan White HIV/AIDS Treatment Modernization Act 

Parts A-F Explained 



Part A: Funding to Metropolitan Areas Part A of 
the Ryan White HIV/AIDS Treatment Modernization 
Act of 2006 provides emergency assistance to Eligible 
Metropolitan Areas (EMAs) and Transitional Grant Areas 
(TGAs) that are most severely affected by the HIV/AIDS 
epidemic. 

Part A money goes to the chief elected official 
(CEO) of the major city or county government in the 
EMA or TGA. The CEO is legally the grantee, but usually 
chooses a department such as the health department 
or other entity to manage the grant. That entity is then 
referred to as the grantee. The grantee, working with 
a Part A planning council, manages the grant by mak- 
ing sure the funds are used correctly and all the rules 
about using Ryan White Part A funds are followed. Part 
A funds may be used for HIV primary medical care and 
other medical related and support services. A limited 
amount of Part A funds can be used for planning, man- 
aging, and evaluating programs, and for supporting the 
work of the planning council. 

Part A grantees are required to use 75 percent of 
their award for core medical services and 25 percent 
for support services. These services may include: 
Core services 

outpatient and ambulatory services 

AIDS pharmaceutical assistance 

oral health 

early intervention services 

health insurance premium 

cost sharing assistance for low-income individuals 

home health care 

medical nutrition therapy 

hospice services 

home and community-based health services 

mental health services; substance abuse outpatient 
care 

medical case management, including treatment 
adherence services 



Support services 

• outreach; 

• medical transportation 

• linguistic services; 

• respite care for person caring for individuals with 
HIV/ AIDS; 

• referrals for health care and other support services; 

• case management 

• substance abuse residential services. 

Ryan White core and support services are defined in 
Appendix VI. 

Part B: State Funding; ADAP Part B provides grants 
to all 50 States, the District of Columbia, Puerto Rico, 
Guam, the U.S. Virgin Islands, and five U.S. Pacific Terri- 
tories or Associated Jurisdictions. Part B grants include 
a base grant, the AIDS Drug Assistance Program (ADAP) 
award, ADAP Supplemental grants and grants to states 
for Emerging Communities - those reporting between 
500 and 999 cumulative reported AIDS cases over the 
most recent 5 years. 

Like Part A funds, Part B funds can be used for 
core medical and support services. A major priority is 
providing medications for people with HIV/AIDS. One of 
the key differences between Part A and B is that states 
awarded Part B funds decide how to spend the funds 
without planning council involvement, although many 
states get input from Part B planning groups. The Ryan 
White legislation gives states flexibility to deliver these 
services under five different Part B programs: 

• The AIDS Drug Assistance Program (ADAP) 

• Health insurance coverage 

• Home and community-based care 

• Services provided through consortia 

• Direct services provided or contracted by the state 

Part B providers may include public or nonprofit enti- 
ties. For-profit entities are eligible only if they are the 
sole available providers of quality HIV care in the area. 



HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



65 



appendix G 



Most states provide some services directly, but 
others work through subcontracts with Part B HIV Care 
Consortia. A consortium is an association of public and 
nonprofit health care and support service providers 
and community-based organizations that plans, devel- 
ops, and delivers services for people living with HIV. 
Services provided through a consortium are considered 
support services. 



AIDS DRUG ASSISTANCE PROGRAM (ADAP) 



The majority Part B and about one third of Ryan White funding is 
earmarked by Congress for the ADAP. Funding for ADAP is given 
to States based on that State's proportion of the nation's living 
AIDS cases. 

The purpose of ADAP is to provide prescription drugs to eligible 
persons living with HIV. The drugs must be approved by the Food 
and Drug Administration. ADAPs can also use funds to pay to 
continue an eligible individual's private health insurance, if it 
has prescription drug coverage, or to fund treatment adherence 
programs for clients. 

For an individual to receive ADAP assistance they must be medi- 
cally diagnosed with HIV. They must qualify as "low income," as 
defined by the state. States receiving ADAP funding have the 
flexibility in designing their program, setting income and medical 
eligibility requirements and developing drug formularies. A drug 
formulary is a listing of all drugs funded by the state's ADAP. 



Eligibility Each State and Territory establishes its 
own eligibility criteria. However, all States/Territories 
are required to implement an ADAP recertification 
process every six months to ensure only eligible clients 
are served. All States/Territories require that program 
participants document their HIV status. Clients must 
be low income, and under or uninsured. Also all ADAPs 
require that clients be residents in their state, and 
most require proof of residency. 

Who receives ADAP funding? ADAP funding goes 
directly to the State/Territory. Community-based orga- 
nizations can apply ADAP referral methodologies to 
funded Ryan White programs. 



Part C: Early Intervention Services, Planning 
Grants & Capacity Development Part C of the 
Ryan White HIV/AIDS Treatment Modernization Act 
of 2006 has three funding areas: early intervention 
services, planning grants, and capacity development 
funding. Eligible applicants must be public or private 
nonprofit entities, including community and faith-based 
organizations, which are or intend to become compre- 
hensive HIV primary care providers. 

Early Intervention Services Part C Early Interven- 
tion Services (EIS) funds comprehensive, outpatient 
primary health care for people living with HIV over five 
cost categories: Early Intervention Services Costs, Core 
Medical Services Costs, Support Services Costs, Qual- 
ity Management Costs, and Administrative Costs. 
Early Intervention Services Costs are those costs asso- 
ciated with the direct provision of medical care and 
make up at least 50 percent of a grantee budget. EIS 
Services Costs cover the following: 

Primary care providers 

Lab, x-ray, and other diagnostic tests 

Medical/dental equipment and supplies 

Medical case management 

Electronic medical records 

Patient education, in conjunction with medical care 

Transportation for clinical care provider staff to 
provide care 

• Other clinical and diagnostic services regarding HIV/ 
AIDS and periodic medical evaluations of individuals 
with HIV/AIDS 

Core Medical Services Costs include those listed 
above, plus the following: 

• HIV counseling 

• AIDS Drug Assistance Program 

• Health insurance premium and cost sharing 
assistance for low income individuals 

• Home health care 

• Hospice cervices 

• Home and community-based health services (as 
defined under Part B) 



66 



I IIV/AII )S: Building ( .i|),i< ii v to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix G 



Clinical Quality Management Costs are those costs 
required to maintain a clinical quality management pro- 
gram. Examples of these costs include: 

• Continuous Quality Improvement (CQI) activities 

• Clinical quality management coordination 

• Data collection for clinical quality management 
purposes 

• Consumer involvement to improve services 

• Staff training/technical assistance to improve 
services 

Support Services Costs, which are for services needed 
for individuals with HIV/AIDS to achieve their medical 
outcomes, include: 

Patient transportation to medical appointments 

Staff travel to provide support services 

Outreach to identify people with HIV, or at-risk of 
contracting HIV 

Translation and interpretation services 

Patient education materials 

Participation in Statewide Coordinated Statement of 
Need process 

Patient advocates to maintain access to care 

Respite care 

Some Administrative Costs covered under Part C 
include: 

Indirect costs 

Rent, utilities, and other facility support costs 

Personnel costs and fringe benefits 

Telecommunications, postage, office supplies 

Liability insurance 

Audits 

Payroll/ Accounting services 

Computer hardware/software 

Program evaluation 

Planning Grants Part C Planning Grants funds eligible 
entities to plan for the provision of high-quality com- 
prehensive HIV primary health care services in rural 
or urban underserved areas and for communities of 
color. Planning grant funds are intended for a period of 



1 year. Planning grants are available for one year and 
support the planning process; they do not fund any ser- 
vice delivery or patient care. Funded activities include: 

• Identifying key stakeholders and bringing potential 
partners into the planning process 

• Gathering a formal advisory group 

• Conducting an in-depth review of the need for HIV 
primary care services in the community (including 
a local epidemiological profile, an evaluation of the 
community's service provider capacity, and a profile 
of the target population) 

• Defining the components of care and forming 
essential program linkages with community 
providers 

• Researching funding sources and applying for 
operational grants 

Capacity Development Grants Capacity Development 
Grants are designed to help public and nonprofit enti- 
ties strengthen their organizational infrastructure and 
enhance their capacity to provide access to HIV primary 
health care services in underserved or rural communi- 
ties, and within all communities of color. Activities sup- 
ported by this funding are short-term and include: 

• Establishing and strengthening clinical, 
administrative, and managerial structures 

• Developing a financial management unit 

• Developing and implementing a clinical continuous 
quality improvement (CQI) program 

• Applying for Medicaid certification and state clinic 
licensure 

• Increasing the capability to oversee HIV 
service provision, including development of an 
organizational strategic plan for HIV care, education 
of Board members regarding the HIV program, and 
staff training and development regarding HIV care 

• Purchasing clinical supplies and equipment for the 
purpose of developing, enhancing, or expanding HIV 
primary care services 

• Developing an organizational strategic plan to 
address managed care changes or changes in the 
HIV epidemic in your community 

• Developing a cultural competency training program 



67 



HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix G 



• Increasing the capability to implement and manage 
consumer involvement 

• Developing a Patient Self Management support 

Part D: Services for infants, children, youth, and 
women with HIV and their families Part D provides 
funds for family-centered care involving outpatient 
or ambulatory care for women, infants, children, and 
youth with HIV/AIDS. The main focus of Part D is to 
identify HIV positive pregnant women and ensure that 
they have access to prenatal care to prevent mother- 
to-child transmission of the virus. Grants are awarded 
competitively to public and private nonprofit organiza- 
tions to provide primary and specialty care such as: 
Substance abuse counseling and treatment 

Mental health services 

Transportation 

Child care 

Housing assistance 

Care coordination 

Access to clinical trials and clinical research 

Support services 

Logistical support and coordination of services 

Part F: Focused Program Areas 

Part F includes three competitive grants: Special Proj- 
ects of National Significance (SPNS); AIDS Education 
and Training Centers (AETCs); and the HIV/AIDS Dental 
Reimbursement Program. 

Special Projects of National Significance (SPNS) 

SPNS supports the development and replication of 
innovative models in HIV/AIDS care and service deliv- 
ery to underserved populations diagnosed with HIV. 
The SPNS Program provides the mechanisms to: 

• Quickly respond to emerging needs of individuals 

• Fund special programs to develop standard 
electronic client information data systems 

• To advance knowledge and skills in the delivery of 
health and support services to people with HIV who 
are underserved 

• Support and assess the effectiveness of new 

innovative programs 



• Fund innovative models of care and to support the 
development of effective delivery systems of HIV 
care and services 

• Promote the sharing and replication of effective 
models of care 

SPNS Initiatives include: 

• Prevention with HIV-infected persons seen in primary 
care settings 

• Evaluation of innovative methods for integrating 
substance abuse treatment in HIV primary care 

• Development of outreach, care, and prevention 
strategies to engage HIV-positive young men who 
have sex with men of color 

• Developing innovative models of care to provide oral 
health care to HIV-positive, underserved populations 

• Enhancement and evaluation of existing health 
information electronic network systems for PLWHA in 
underserved communities 

• Enhancement of linkages to HIV primary care in jail 
settings 

• Capacity-building to develop standard electronic 
client information data systems 

AIDS Education and Training Centers (AETCs) 

AETCs are the clinical training component of Ryan 
White. AETCs seek to improve health outcomes of 
people living with HIV/AIDS through training on clinical 
management of HIV disease in such areas as use of 
antiretroviral therapies and prevention of HIV transmis- 
sion. The program targets providers who treat minority, 
underserved, and vulnerable populations in communi- 
ties hard hit by the HIV epidemic. 

HIV/AIDS Dental Reimbursement Program 

The Ryan White HIV/AIDS Dental Reimbursement Pro- 
grams were created to address difficulties in access to 
dental care for persons living with HIV/AIDS. The pro- 
grams provide funding for dental schools, postdoctoral 
dental programs and dental hygiene programs for the 
services they provide to uninsured individuals living 
with HIV/AIDS. 



68 



I II II A: Huildiiii' ( ipacityto Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix H 



Ryan White Program Definitions 



Core Medical Services 

Outpatient/Ambulatory medical care 
(health services) is the provision 
of professional diagnostic and 
therapeutic services rendered by 
a physician, physician's assistant, 
clinical nurse specialist, or nurse 
practitioner in an outpatient setting. 
Settings include clinics, medical 
offices, and mobile vans where clients 
generally do not stay overnight. 
Emergency room services are not 
outpatient settings. Services includes 
diagnostic testing, early intervention 
and risk assessment, preventive 
care and screening, practitioner 
examination, medical history taking, 
diagnosis and treatment of common 
physical and mental conditions, 
prescribing and managing medication 
therapy, education and counseling 
on health issues, well-baby care, 
continuing care and management of 
chronic conditions, and referral to and 
provision of specialty care (includes 
all medical subspecialties). Primary 
medical care for the treatment of 
HIV infection includes the provision 
of care that is consistent with the 
Public Health Service's guidelines. 
Such care must include access 
to a nti retroviral and other drug 
therapies, including prophylaxis and 
treatment of opportunistic infections 
and combination a nti retroviral 
therapies. NOTE: Early Intervention 
Services provided by Ryan White 
Part C and Part D Programs should 
be included here under Outpatient/ 
Ambulatory medical care. 

AIDS Drug Assistance Program (ADAP 
treatments) is a State-administered 
program authorized under Part B of 
the Ryan White Program that provides 
FDA-approved medications to low- 
income individuals with HIV disease 
who have limited or no coverage 
from private insurance, Medicaid, or 
Medicare. 



AIDS Pharmaceutical Assistance 
(local) includes local pharmacy 
assistance programs implemented by 
Part A or Part B Grantees to provide 
HIV/AIDS medications to clients. This 
assistance can be funded with Part A 
grant funds and/or Part B base award 
funds. Local pharmacy assistance 
programs are not funded with ADAP 
earmark funding. 

Oral health care includes diagnostic, 
preventive, and therapeutic 
services provided by general dental 
practitioners, dental specialists, 
dental hygienists and auxiliaries, and 
other trained primary care providers. 

Early intervention services (EIS) 

include counseling individuals with 
respect to HIV/AIDS; testing (including 
tests to confirm the presence of 
the disease, tests to diagnose to 
extent of immune deficiency, tests to 
provide information on appropriate 
therapeutic measures); referrals; 
other clinical and diagnostic services 
regarding HIV/AIDS; periodic medical 
evaluations for individuals with HIV/ 
AIDS; and providing therapeutic 
measures. 

Health Insurance Premium & Cost 
Sharing Assistance is the provision 
of financial assistance for eligible 
individuals living with HIV to maintain 
a continuity of health insurance or 
to receive medical benefits under 
a health insurance program. This 
includes premium payments, risk 
pools, co-payments, and deductibles. 

Home Health Care includes the 
provision of services in the home by 
licensed health care workers such 
as nurses and the administration 
of intravenous and aerosolized 
treatment, parental feeding, 
diagnostic testing, and other medical 
therapies. 



Home and Community-based Health 
Services include skilled health 
services furnished to the individual 
in the individual's home based on a 
written plan of care established by a 
case management team that includes 
appropriate health care professionals. 
Services include durable medical 
equipment; home health aide 
services and personal care services 
in the home; day treatment or other 
partial hospitalization services; 
home intravenous and aerosolized 
drug therapy (including prescription 
drugs administered as part of 
such therapy); routine diagnostics 
testing administered in the home; 
and appropriate mental health, 
developmental, and rehabilitation 
services. Inpatient hospitals services, 
nursing home and other long term 
care facilities are NOT included. 

Hospice services include room, board, 
nursing care, counseling, physician 
services, and palliative therapeutics 
provided to clients in the terminal 
stages of illness in a residential 
setting, including a non-acute-care 
section of a hospital that has been 
designated and staffed to provide 
hospice services for terminal clients. 

Mental health services are 

psychological and psychiatric 
treatment and counseling services 
offered to individuals with a 
diagnosed mental illness, conducted 
in a group or individual setting, 
and provided by a mental health 
professional licensed or authorized 
within the State to render such 
services. This typically includes 
psychiatrists, psychologists, and 
licensed clinical social workers. 



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appendix H 



Medical nutrition therapy is provided 
by a licensed registered dietitian 
outside of a primary care visit and 
includes the provision of nutritional 
supplements. Medical nutrition 
therapy provided by someone 
other than a licensed/registered 
dietitian should be recorded under 
psychosocial support services. 

Medical Case management services 
(including treatment adherence) are 

a range of client-centered services 
that link clients with health care, 
psychosocial, and other services. The 
coordination and follow-up of medical 
treatments is a component of medical 
case management. These services 
ensure timely and coordinated access 
to medically appropriate levels of 
health and support services and 
continuity of care, through ongoing 
assessment of the client's and other 
key family members' needs and 
personal support systems. Medical 
case management includes the 
provision of treatment adherence 
counseling to ensure readiness for, 
and adherence to, complex HIV/ 
AIDS treatments. Key activities 
include (1) initial assessment of 
service needs; (2) development of a 
comprehensive, individualized service 
plan; (3) coordination of services 
required to implement the plan; 
(4) client monitoring to assess the 
efficacy of the plan; and (5) periodic 
re-evaluation and adaptation of the 
plan as necessary over the life of 
the client. It includes client-specific 
advocacy and/or review of utilization 
of services. This includes all types of 
case management including face-to- 
face, phone contact, and any other 
forms of communication. 



Substance abuse services outpatient 

is the provision of medical or other 
treatment and/or counseling to 
address substance abuse problems 
(i.e., alcohol and/or legal and illegal 
drugs) in an outpatient setting, 
rendered by a physician or under the 
supervision of a physician, or by other 
qualified personnel. 



Core Support Services 

Case Management (non-medical) 

includes the provision of advice and 
assistance in obtaining medical, 
social, community, legal, financial, 
and other needed services. Non- 
medical case management does not 
involve coordination and follow-up of 
medical treatments, as medical case 
management does. 

Child care services are the provision 
of care for the children of clients 
who are HIV-positive while the clients 
attend medical or other appointments 
or Ryan White Program-related 
meetings, groups, or training. 
NOTE: This does not include child 
care while a client is at work. 

Pediatric developmental assessment 
and early intervention services 

are the provision of professional 
early interventions by physicians, 
developmental psychologists, 
educators, and others in the 
psychosocial and intellectual 
development of infants and 
children. These services involve the 
assessment of an infant's or child's 
developmental status and needs 
in relation to the involvement with 
the education system, including 
early assessment of educational 



intervention services. It includes 
comprehensive assessment of 
infants and children, taking into 
account the effects of chronic 
conditions associated with HIV, 
drug exposure, and other factors. 
Provision of information about access 
to Head Start services, appropriate 
educational settings for HIV-affected 
clients, and education/assistance to 
schools should also be reported in 
this category. 

Emergency financial assistance is the 

provision of short-term payments to 
agencies or establishment of voucher 
programs to assist with emergency 
expenses related to essential utilities, 
housing, food (including groceries, 
food vouchers, and food stamps), and 
medication when other resources are 
not available. 

Food bank/home-delivered meals 

include the provision of actual food or 
meals. It does not include finances to 
purchase food or meals. The provision 
of essential household supplies such 
as hygiene items and household 
cleaning supplies should be included 
in this item. Includes vouchers to 
purchase food. 

Health education/risk reduction 

is the provision of services that 
educate clients with HIV about HIV 
transmission and how to reduce the 
risk of HIV transmission. It includes 
the provision of information; including 
information dissemination about 
medical and psychosocial support 
services and counseling to help 
clients with HIV improve their health 
status. 



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HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix H 



Housing services are the provision 
of short-term assistance to support 
emergency, temporary or transitional 
housing to enable an individual or 
family to gain or maintain medical 
care. Housing-related referral 
services include assessment, 
search, placement, advocacy, and 
the fees associated with them. 
Eligible housing can include both 
housing that does not provide direct 
medical or supportive services and 
housing that provides some type 
of medical or supportive services 
such as residential mental health 
services, foster care, or assisted living 
residential services. 

Legal services are the provision of 
services to individuals with respect to 
powers of attorney, do-not-resuscitate 
orders and interventions necessary 
to ensure access to eligible benefits, 
including discrimination or breach of 
confidentiality litigation as it relates 
to services eligible for funding under 
the Ryan White Program. It does 
not include any legal services that 
arrange for guardianship or adoption 
of children after the death of their 
normal caregiver. 

Linguistics services include the 
provision of interpretation and 
translation services. 

Medical transportation services 
include conveyance services 
provided, directly or through voucher, 
to a client so that he or she may 
access health care services. 



Outreach services are programs 
that have as their principal purpose 
identification of people with unknown 
HIV disease or those who know their 
status so that they may become 
aware of, and may be enrolled in 
care and treatment services (i.e., 
case finding), not HIV counseling and 
testing nor HIV prevention education. 
These services may target high-risk 
communities or individuals. Outreach 
programs must be planned and 
delivered in coordination with local 
HIV prevention outreach programs 
to avoid duplication of effort; be 
targeted to populations known 
through local epidemiologic data to 
be at disproportionate risk for HIV 
infection; be conducted at times 
and in places where there is a high 
probability that individuals with HIV 
infection will be reached; and be 
designed with quantified program 
reporting that will accommodate local 
effectiveness evaluation. 

Permanency planning is the provision 
of services to help clients or families 
make decisions about placement 
and care of minor children after the 
parents/caregivers are deceased or 
are no longer able to care for them. 

Psychosocial support services are the 

provision of support and counseling 
activities, child abuse and neglect 
counseling, HIV support groups, 
pastoral care, caregiver support, and 
bereavement counseling. Includes 
nutrition counseling provided 
by a non-registered dietitian but 
excludes the provision of nutritional 
supplements. 



Referral for health care/supportive 
services is the act of directing 
a client to a service in person or 
through telephone, written, or other 
type of communication. Referrals may 
be made within the non-medical case 
management system by professional 
case managers, informally through 
support staff, or as part of an 
outreach program. 

Rehabilitation services are services 
provided by a licensed or authorized 
professional in accordance with an 
individualized plan of care intended 
to improve or maintain a client's 
quality of life and optimal capacity for 
self-care. Services include physical 
and occupational therapy, speech 
pathology, and low-vision training. 

Respite care is the provision of 
community or home-based, non- 
medical assistance designed 
to relieve the primary caregiver 
responsible for providing day-to-day 
care of a client with HIV/AIDS. 

Substance abuse services-residential 

is the provision of treatment to 
address substance abuse problems 
(including alcohol and/or legal and 
illegal drugs) in a residential health 
service setting (short-term). 

Treatment adherence counseling is 

the provision of counseling or special 
programs to ensure readiness for, 
and adherence to, complex HIV/AIDS 
treatments by non-medical personnel 
outside of the medical case 
management and clinical setting. 



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HIV/ AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



appendix I 



Other Government Resource and 
Technical Assistance Opportunites 



Office of Public Health and Science (OPHS) 

The Office of Public Health and Science (OPHS, www. 
hhs.gov/ophs) is made up of 12 core public health 
offices and the Commissioned Corps, a uniformed 
service of more than 6,000 health professionals who 
serve at HHS and other federal agencies. 

HIV/AIDS Related Offices and Initiatives 

The offices under OPHS offer a range of resources, 
trainings, technical assistance and funding opportuni- 
ties in public health. Several offices have HIV/AIDS 
awareness building programs and organizational 
capacity building initiatives. There are key OPHS offices 
that also have Minority AIDS Initiative (MAI) funding 
that they are responsible for distributing funds to 
grantees serving ethnic minority communities hardest 
hit by HIV/AIDS. The following are the key offices under 
OPHS that have HIV/AIDS specific technical assistance 
resources and MAI funding: 

Office of HIV/AIDS Policy (OHAP) is the primary clear- 
inghouse for all HHS efforts in the area of HIV/AIDS. 
OHAP advises senior HHS officials on the development 
and implementation of HIV/AIDS policy and the imple- 
mentation of HIV/AIDS programs across HHS agencies. 
OHAP also sponsors the National HIV Testing Mobiliza- 
tion Campaign (NHTMC), a nationwide effort to promote 
HIV testing. Learn more about OHAP technical assis- 
tance opportunities at www.hhs.gov/ophs/ohap. 



Office of Minority Health (OMH) is the federal focal 
point for addressing the health status and quality of life 
for racial and ethnic minority populations in the U.S. 
OMH coordinates special initiatives targeting minori- 
ties, including the HHS Minority HIV/AIDS Initiative, the 
HHS Disparities Initiative, the White House Initiative on 
Historically Black Colleges and Universities, the White 
House Initiative on Educational Excellence for Hispanic 
Americans, and the White House Initiative on Tribal 
Colleges and Universities (read about these at www. 
omhrc.gov). 

Office on Women's Health (OWH) strives to improve 
the health of American women by advancing and 
coordinating a comprehensive women's health agenda 
throughout HHS. OWH runs a number of HIV/AIDS pro- 
grams, which are described on their Web site at www. 
womenshealth.gov/owh. 

Office of Population Affairs (OPA) advises the Secre- 
tary and the Assistant Secretary for Health on a wide 
range of reproductive health topics, including adoles- 
cent pregnancy, family planning, and other population 
issues. OPA has three initiatives, 1) Parents Speak up 
National Campaign, 2) HIV Prevention Integration Initia- 
tive, and 3) Male Involvement Initiative. You can find 
out about these initiatives and opportunities for your 
organization at www.hhs.gov/opa. 



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appendix I 



Special Populations and Initiatives 

White House Faith-Based & Community Initiative 

The White House Office of Faith-based and Community 
Initiatives and Centers for Faith-Based and Community 
Initiatives in eleven federal agencies were created to 
help strengthen and expand the role of faith-based 
community organizations (FBCOs) in providing social 
services. The initiative's Web site (www.whitehouse. 
gov/government/fbci) provides information on publica- 
tions and technical assistance opportunities to help 
your organization navigate the federal grants system. 

Focus of the Initiative 

• Identifying and eliminating barriers that impede 
the full participation of FBCOs in the federal 
grants process 

• Ensuring that federally-funded social services 
administered by state and local governments are 
consistent with equal treatment provisions 

• Encouraging greater corporate and philanthropic 
support for FBCOs' social service programs 
through public education and outreach activities 

• Pursuing legislative efforts to extend charitable 
choice provisions that prevent discrimination 
against faith-based organizations, protect the 
religious freedom of beneficiaries, and preserve 
religious hiring rights of faith-based charities 



Indian Health Services 

The Indian Health Services' (IHS, www.ihs.gov) mission 
is to promote the physical, mental, social, and spiritual 
health of American Indians and Alaska Natives (AI/AN). 
The IHS' goal is to assure that comprehensive, cultur- 
ally acceptable public health services are available for 
American Indian and Alaska Native communities. 

IHS HIV/ AIDS Program 

The IHS HIV/AIDS Program (www.ihs.gov/MedicalPro- 
grams/HIVAIDS) includes HIV/AIDS prevention and 
treatment services provided by all IHS local health ser- 
vice programs, with the goals of: 

• Helping AI/AN individuals become aware of their 
HIV status 

• Reducing the number of new AI/AN HIV infections 
annually 

• Reducing HIV transmission in the community 
through prevention education 

• Ensuring access to quality health services for Al/ 
AN individuals and families living with HIV/AIDS 

• Forming sustainable collaborations to maximize 
resources for American Indian and Alaska Native 
HIV/AIDS prevention and treatment 



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Glossary of HIV/AIDS Terms 3 



AIDS Drug Assistance Program 
(A DAP) 

Administered by States and 
authorized under Part B of the 
Ryan White HIV/AIDS Treatment 
Modernization Act. Provides FDA- 
approved medications to low-income 
individuals with HIV disease who 
have limited or no coverage from 
private insurance or Medicaid. ADAP 
funds may also be used to purchase 
insurance for uninsured Ryan White 
HIV/AIDS Program clients as long as 
the insurance costs do not exceed 
the cost of drugs through ADAP, 
and the drugs available through the 
insurance program at least match 
those offered through ADAP. 

Administrative or Fiscal Agent 

Entity that functions to assist a 
grantee, consortium, or other 
planning body in carrying out 
administrative activities (e.g., 
disbursing program funds, developing 
reimbursement and accounting 
systems, developing Requests 
for Proposals (RFPs), monitoring 
contracts). 

AETC (see Appendix V, Part F) 

Acquired Immunodeficiency 
Syndrome (AIDS) 

A disease caused by the human 
immunodeficiency virus. 

Antiretroviral 

A substance that fights against a 
retrovirus, such as HIV. 

AIDS service organization (ASO) 

An organization that provides primary 
medical care and/or support services 
to populations infected with and 
affected by HIV disease. 



3 Many of the terms included in this 
glossary were taken from HRSA's The 
HIV/AIDS Program: Glossary of Terms, 
http://hab.hrsa.gov/history/webterms. 
htm. 



Capacity 

Core competencies that substantially 
contribute to an organization's 
ability to deliver effective HIV/AIDS 
primary medical care and health- 
related support services. Capacity 
development activities should 
increase access to the HIV/AIDS 
service system and reduce disparities 
in care among underserved people 
living with HIV/AIDS. 

Ryan White Comprehensive AIDS 
Resources Emergency Act (CARE 
Act) 

Federal legislation created to 
address the unmet health care 
and service needs of people living 
with HIV Disease (PLWH) and their 
families. It was enacted in 1990 and 
reauthorized in 1996 and 2000. 
The CARE Act was reauthorized in 
2006 as the Ryan White HIV/AIDS 
Treatment Modernization Act. 

Community-based organization (CBO) 

An organization that provides services 
to locally defined populations. 

Centers for Disease Control and 
Prevention (CDC) 

Federal agency within HHS that 
administers disease prevention 
programs, including HIV/AIDS 
prevention. 

Chief Elected Official (CEO) 

The official recipient of Part A or Part 
B Ryan White HIV/AIDS Program 
funds. For Part A, this is usually a city 
mayor, county executive, or chair of 
the county board of supervisors. For 
Part B, this is usually the governor. 
The CEO is ultimately responsible 
for administering all aspects of their 
title's CARE Act funds and ensuring 
that all legal requirements are met. 

Centers for Medicare and Medicaid 
Services (CMS) 

Federal agency within HHS that 
administers the Medicaid, Medicare, 
State Child Health Insurance Program 



(SCHIP), and the Health Insurance 
Portability and Accountability Act 
(HIPAA). 

Community Forum or Public Meeting 

A small-group method of collecting 
information from community 
members in which a community 
meeting is used to provide a directed 
but highly interactive discussion. 
Similar to but less formal than a focus 
group, it usually includes a larger 
group; participants are often self- 
selected (i.e., not randomly selected 
to attend). 

Comprehensive Planning 

The process of determining the 
organization and delivery of HIV 
services. This strategy is used by 
planning bodies to improve decision- 
making about services and maintain 
a continuum of care for people living 
with HIV/AIDS. 

Community Health Centers 

Federally-funded by HRSA's Bureau 
of Primary Health Care, centers 
provide family-oriented primary and 
preventive health care services for 
people living in rural and urban 
medically underserved communities. 

Consortium/HIV Care Consortium 

A regional or statewide planning 
entity established by many state 
grantees under Part B of the Ryan 
White HIV/AIDS Program to plan 
and sometimes administer Part B 
services. An association of health 
care and support service agencies 
serving people living with HIV/AIDS 
under Part B. 

Continuum of Care 

An approach that helps communities 
plan for and provide a full range of 
emergency and long-term service 
resources to address the various 
needs of people living with HIV/AIDS. 



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HIV/AIDS: Building Capacity to Better Serve Your Community • A Guide to Strengthening HIV/AIDS Services 



glossary of HIV/AIDS Terms 



Cultural Competence 

The knowledge, understanding, 
and skills to work effectively with 
individuals from differing cultural 
backgrounds. 

Early Intervention Services (EIS) 
Activities designed to identify 
individuals who are HIV-positive and 
get them into care as quickly as 
possible. As funded through Parts 
A and B of the Ryan White HIV/ 
AIDS Program, includes outreach, 
counseling and testing, information 
and referral services. Under Part C of 
the Ryan White HIV/AIDS Program. 
EIS also include comprehensive 
primary medical care for individuals 
living with HIV/AIDS. 

Eligible Metropolitan Area (EMA) 
Geographic areas highly impacted by 
HIV/AIDS that are eligible to receive 
Ryan White HIV/AIDS Program Part A 
funds. To be an eligible EMA. an area 
must have reported more than 2.000 
AIDS cases in the most recent 5 years 
and have a population of at least 
50.000. 

Epidemic 

A disease that occurs clearly in 
excess of normal expectation 
and spreads rapidly through a 
demographic segment of the human 
population. Epidemic diseases can 
be spread from person to person, or 
from a contaminated source such as 
food or water. 

Epidemiology 

The branch of medical science that 
studies the incidence, distribution, 
and control of disease in a 
population. 

Family Centered Care 

A model in which systems of care 
under Ryan White Part D are 
designed to address the needs of 
people living with HIV/AIDS and 
affected family members as a unit, 
providing or arranging for a full range 
of services. Family structures may 
range from the traditional, biological 
family unit to non-traditional family 
units with partners, significant others, 
and unrelated caregivers. 



Grantee 
The recipient of Ryan White HIV/ 
AIDS Program funds responsible for 
administering the award. 

Health Insurance Continuity Program 
(HICP) 

A program primarily under Part B of 
the Ryan White HIV/AIDS Program 
that makes premium payments, 
co-payments, deductibles, and/or risk 
pool payments on behalf of a client to 
purchase/maintain health insurance 
coverage. 

HIV/AIDS Bureau (HAB) 

The bureau within HRSA that is 
responsible for administering the 
Ryan White HIV/ AIDS Treatment 
Modernization Act. 

HIV/AIDS Dental Reimbursement 
Program 

The program within the HAB's Division 
of Community Based Programs that 
assists with uncompensated costs 
incurred in providing oral health 
treatment to people living with HIV/ 
AIDS. 

HIV Disease 
Any signs, symptoms, or other 
adverse health effects due to the 
human immunodeficiency virus. 

Home and Community Based Care 

A category of eligible services that 
states may fund under Part B of the 
Ryan White HIV/AIDS Program. 

Health Resources and Services 
Administration (HRSA) 
The agency within HHS that 
administers various primary 
care programs for the medically 
underserved, including the Ryan 
White HIV/AIDS Program. 

Injection Drug User (IDU) 

Lead Agency 

The agency within a Part B consortium 
that is responsible for contract 
administration; also called a fiscal 
agent (an incorporated consortium 
sometimes serves as the lead 
agency). 



Minority AIDS Initiative (MAI) 
An HHS initiative that provides 
special resources to reduce the 
spread of HIV/AIDS and improve 
health outcomes for people living 
with HIV/AIDS within communities 
of color. Enacted to address the 
disproportionate impact of the 
disease in such communities. 
Formerly referred to as the 
Congressional Black Caucus Initiative 
because of that body's leadership in 
its development. 

Needs Assessment 

A process of collecting information 
about the needs of people living with 
HIV/AIDS (both those receiving care 
and those not in care), identifying 
current resources (Ryan White HIV/ 
AIDS Program and other) available to 
meet those needs, and determining 
what gaps in care exist. 

Part A 

The part of the Ryan White HIV/AIDS 
Program that provides emergency 
assistance to EMAs disproportionately 
affected by the HIV/AIDS epidemic. 

PartB 

The part of the Ryan White HIV/ 
AIDS Program that provides funds 
to states and territories for primary 
health care (including HIV treatments 
through ADAP) and support services 
that enhance access to care for 
people living with HIV/AIDS and their 
families. 

PartC 

The part of the Ryan White HIV/AIDS 
Program that supports outpatient 
primary medical care and early 
intervention services to people 
living with HIV/AIDS through grants 
to public and private non-profit 
organizations. Part C also funds 
capacity development and planning 
grants to prepare programs to provide 
EIS services. 

Part D 

The part of the Ryan White HIV/AIDS 
Program that supports coordinated 
services and access to research for 
children, youth, and women with HIV 
disease and their families. 



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glossary of HIV/AIDS Terms 



Part F - AIDS Education and Training 
Centers (AETCs) 

Regional centers providing education 
and training for primary care 
professionals and other AIDS-related 
personnel. AETCs are authorized 
under Part F of the Ryan White HIV/ 
AIDS Program and administered by 
the HRSA HIV/AIDS Bureau's Division 
of Training and Technical Assistance 
(DTTA). 

Part F - Special Projects of National 
Significance (SPNS) 

A health services demonstration, 
research, and evaluation program 
funded under Part F of the Ryan 
White HIV/AIDS Program to identify 
innovative models of HIV care. SPNS 
projects are awarded competitively. 

Planning Council 

A planning body appointed or 
established by the Chief Elected 
Official of an EMA whose basic 
function is to assess needs, establish 
a plan for the delivery of HIV care 
in the EMA, and establish priorities 
for the use of Ryan White HIV/AIDS 
Program Part A funds. 

Planning Process 

Steps taken and methods used to 
collect information, analyze and 
interpret it, set priorities, and prepare 
a plan for rational decision making. 

PLWHA (People Living with HIV/AIDS) 

Priority Setting 

The process used to establish 
priorities among service categories, 
to ensure consistency with locally 
identified needs, and to address how 
best to meet each priority. 

Quality 

The degree to which a health or social 
service meets or exceeds established 
professional standards and user 
expectations. 



Quality Assurance (QA) 

The process of identifying problems in 
service delivery, designing activities 
to overcome these problems, and 
following up to ensure that no new 
problems have developed and 
that corrective actions have been 
effective. The emphasis is on meeting 
minimum standards of care. 

Request for Proposals (RFP) 

An open and competitive process 
for selecting providers of services 
(sometimes called a Request for 
Application or RFA). 

Resource Allocation 

The responsibility of the Part A 
planning council to assign Ryan 
White HIV/AIDS Program amounts or 
percentages to established priorities 
across specific service categories, 
geographic areas, populations, or 
subpopulations. 

Ryan White HIV/AIDS Treatment 
Modernization Act of 2006 (Ryan 
White Program) 

Enacted in 2006, this legislation 
reauthorized the Ryan White Program, 
formerly called the Ryan White CARE 
Act. 

Statewide Coordinated Statement of 
Need (SCSN) 

A written statement of need for the 
entire state developed through a 
process designed to collaboratively 
identify significant HIV issues and 
maximize Ryan White HIV/AIDS 
Program coordination. The SCSN 
process is convened by the Part B 
grantee, with equal responsibility and 
input by all programs. 

Section 340B Drug Discount Program 

A program administered by the 
HRSA's Bureau of Primary Care, Office 
of Pharmacy Affairs established by 
Section 340B of the Veteran's Health 
Care Act of 1992, which limits the 
cost of drugs to Federal purchasers 
and to certain grantees of Federal 
agencies. 



Service Gaps 

All the service needs of PLWHA, 
except for the need for primary health 
care for individuals who know their 
status but are not in care. Service 
gaps include additional need for 
primary health care for those already 
receiving primary medical care. 

STD (Sexually Transmitted Disease) 

Technical Assistance (TA) 

The delivery of practical program 
and technical support to the CARE 
Act community. TA is to assist 
grantees, planning bodies, and 
affected communities in designing, 
implementing, and evaluating Ryan 
White - supported planning and 
primary care service delivery systems. 

Transitional Grant Area (TGA) 

Designation under Part A of the Ryan 
White Program. To be eligible as a 
TGA, an area must have reported at 
least 1,000, but fewer than 2,000 
new AIDS cases in the most recent 5 
years. 

Target Population 

A population to be reached through 
some action or intervention; may refer 
to groups with specific demographic 
or geographic characteristics. 



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